Antipsychotic medication for challenging behaviour in people with learning disability

Brylewski, Jane; Duggan, Lorna

doi:10.1002/14651858.cd000377.pub2

Cited by 73 publications

(58 citation statements)

References 40 publications

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“…Until recently, there were few RCTs of psychotropics in people with DDs, 60 or RCTs were old and included medications no longer in use or did not include contemporary medications 61 ; however, the number of RCTs has increased, resulting in several systematic reviews and meta-analyses. The following section will review the evidence for pharmacotherapy, first for ASDs and then for IDs.…”

Section: Pharmacotherapymentioning

confidence: 99%

Treatment of Psychopathology in People with Intellectual and other Disabilities

Sturmey

2012

Can J Psychiatry

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Objective: To review the psychosocial, pharmacological, and other treatments of psychopathology in people with intellectual disabilities (IDs), autism, and other developmental disabilities (DDs).Method: Systematic reviews and meta-analyses of psychosocial, pharmacological, and other treatments for people with DDs are reviewed. Results:There is strong evidence for applied behaviour analysis (ABA) and other behavioural treatments of some forms of psychopathology. There is little good evidence to support the effectiveness of cognitive-behavioural therapy, cognitive therapy, sensory interventions, and other forms of psychosocial interventions. Recently, more randomized controlled trials (RCTs) of psychopharmacology have been published, especially with people with autism spectrum disorders. Most RCTs were for externalizing behaviour problems, rather than for psychopathology. These RCTs offer only preliminary support for the effectiveness of pharmacotherapy. No evidence was found for the effectiveness of other biological treatments. Conclusions:Current research supports the use of ABA and other behavioural interventions for some forms of psychopathology. Evidence for the effectiveness of other interventions is limited or absent.

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Section: Pharmacotherapymentioning

confidence: 99%

Treatment of Psychopathology in People with Intellectual and other Disabilities

Sturmey

2012

Can J Psychiatry

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“…There is evidence to support the positive impact of behavioural interventions for problem behaviours (Matson, Benavidez, Compton, Paclawskyj, & Baglio, 1996, Didden, 1997Didden 2007) in adults with intellectual disabilities. However, whilst still commonly used, there is very little robust evidence to support the use of psychotropic medication in the management of problem behaviours in adults with intellectual disabilities (Brylewski & Duggan, 2004) or autism spectrum disorders (Kwok, 2003). Furthermore, the side effects of medication can lead to psychopathology or problem behaviours, and therefore, the use of medication in the management of problem behaviours should be part of an integrated, multidisciplinary management plan, and should be closely monitored for effectiveness and adverse effects (Deb, Clarke, & Unwin, 2006).…”

Section: Mental Ill-health 20mentioning

confidence: 99%

The Prevalence and Incidence of Mental Ill-Health in Adults with Autism and Intellectual Disabilities

Melville

Cooper

Morrison

et al. 2008

J Autism Dev Disord

115

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The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem behaviours compared with the whole adult population with intellectual disabilities, compared with individually matched controls there was no difference in prevalence, or incidence of either problem behaviours or other mental ill-health. Adults with autism who had problem behaviours were less likely to recover over a two-year period than were their matched controls. Apparent differences in rates of mental ill-health are accounted for by factors other than autism, including Down syndrome and ability level.

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“…Brylewski and Duggin [35] in the most recent Cochrane Review of the field found only 9 RCTs on antipsychotic treatments of behavioral difficulties in patients with Intellectual Disability since 1990. They judged the studies to be of poor quality making it extremely difficult to evaluate the efficacy of psychotropic medications in this population.…”

Section: Discussionmentioning

confidence: 99%

A Review of Empirical Evidence of Somatic Treatment Options for the MI/DD Population

Ulzen

Powers

2008

Psychiatr Q

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This article reviews recent evidence in the literature for the use of psychotropic and other somatic treatments in the management of patients with mental retardation (MR). The search methodology included peer-reviewed English language publications in PubMed and PsychINFO with the words Mental Retardation, Intellectual Disability, Developmental Disability and Mental Disorders/Drug Therapy or Antipsychotic medications, Psychiatric Somatic therapies, Neuroleptic Drugs, Antidepressants and Electroconvulsive Therapy from 1998 to 2008. The review revealed few randomized controlled trials on the medications frequently prescribed for patients with MR. Three RCTs of Risperidone in children, one combining adults and children and one with adults only are discussed. There was one RCT involving Quetiapine and one on Citalopram. There is little evidence to support the scope of psychotropic medication use in the MR population though the field is advancing. The contribution of psychiatric illness to challenging behaviors is not systematically addressed in the literature.

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Antipsychotic medication for challenging behaviour in people with learning disability

Cited by 73 publications

References 40 publications

Treatment of Psychopathology in People with Intellectual and other Disabilities

Treatment of Psychopathology in People with Intellectual and other Disabilities

The Prevalence and Incidence of Mental Ill-Health in Adults with Autism and Intellectual Disabilities

A Review of Empirical Evidence of Somatic Treatment Options for the MI/DD Population

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