Fluoxetine Treatment of Severe Self-Injury in Young Adults with Mental Retardation

Self‐Injurious Behaviour in Children with Learning Disabilities: Recent Advances in Assessment and Intervention

“…The first substantial evidence came from the effective but transient influence of 5-hydroxytryptophan on self-injury in Lesch-Nyhan syndrome (Mizuno &: Yugari, 1974) but this finding was not replicated in later trials (Frith, Johnstone, Joseph, Powell & Watts, 1976). There has been an increase in interest recently, with reports of Fluoxetine and Clomipramine being effective in open clinical trials (Ricketts et al, 1993b) and an interesting report of Fluoxetine precipitating "selfdestructive phenomena" (King et al, 1991b). There has been a number of case studies that report the seemingly compulsive nature of self-injury in some subjects and clomipramine and fluoxetine have been used with some success in the treatment of obsessive compulsive disorders (Ricketts et al, 1993b).…”

Serotonergic antidepressant effects on aggressive, self-injurious and destructive/disruptive behaviours in intellectually disabled adults: a retrospective, open-label, naturalistic trial

“…SIB diminished qualitatively at 1 month and increased above baseline as time passed. Similar tolerance to or decreasing effectiveness of SSRIs or clomipramine was noted in persons with LeschNyhan Syndrome (Nyhan et al, 1980) and PraderWilli Syndrome (Dech and Budow, 1991), and in cases of non-specific mental retardation (Ricketts et al, 1993). Branford et al (1998), in a retrospective case analysis of 37 adults with intellectual disability who received fluoxetine or paroxetine, found that these SSRIs proved of no benefit in 40 %, and led to deterioration in 25 %.…”

Selective serotonin reuptake inhibitors in intellectual disability

“…Based on their performance in paradigms such as the forced swim test, exploration of a black and white test box, foot-shock-induced ultrasonic vocalization, or isolation-induced aggression, serotonergic drugs were nominated to have antidepressant, antianxiety, and antiaggressive effects, respectively [Sanchez and Meier, 1997]. Clinical experience has borne out these effects, and has also suggested a role for serotonergic treatment of behaviors such as hoarding, compulsivity, and self-aggression [Markowitz, 1992;King, 1993;Wiener and Lamberti, 1993;Ricketts et al, 1993;Campbell and Duffy, 1995;Barak et al, 1995;Lewis et al, 1995;Hellings et al, 1996;Lewis et al, 1996;Verhoeven and Tuinier, 1996;Davanzo et al, 1998;Branford et al, 1998]. …”