Pharmacological Intervention for Disruptive Behaviors in Intellectual and Developmental Disabilities

Farmer, Cristan; Aman, Michael G.

doi:10.1016/b978-0-12-401662-0.00009-9

Cited by 7 publications

(6 citation statements)

References 120 publications

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“…Given the possibility that individuals with intellectual disabilities may be more susceptible to drug side-effects, and the lack of firm evidence for the effectiveness of anticonvulsants, GABA analogues and antioxidants, clinicians must be cautious when choosing to prescribe drugs off-label for the treatment of challenging behaviour [ 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Pharmacological interventions for challenging behaviour in children with intellectual disabilities: a systematic review and meta-analysis

et al. 2015

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BackgroundPsychotropic medications are frequently used to treat challenging behaviour in children with intellectual disabilities, despite a lack of evidence for their efficacy. This systematic review and meta-analysis aimed to determine the safety and efficacy of pharmacological interventions for challenging behaviour among children with intellectual disabilities.MethodsElectronic databases were searched and supplemented with a hand search of reference lists and trial registries. Randomised controlled trials of pharmacological interventions for challenging behaviour among children with intellectual disabilities were included. Data were analysed using meta-analysis or described narratively if meta-analysis was not possible. For quality assessment, the Cochrane Risk of Bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were used.ResultsFourteen studies including 912 participants met inclusion criteria. Antipsychotic medication reduced challenging behaviour among children with intellectual disabilities in the short-term (SMD = −1.09, p < 0.001 for risperidone; SMD = −0.64, p <0.001 for aripiprazole). However, there were significant side-effects including elevated prolactin levels (SMD = 3.22, p < 0.001) and weight gain (SMD = 0.82, p < 0.001). Evidence was inconclusive regarding the effectiveness of anticonvulsants and antioxidants for reducing challenging behaviour. The quality of all evidence was low and there were no long term follow up studies.ConclusionsAntipsychotic medications appear to be effective for reducing challenging behaviour in the short-term among children with intellectual disabilities, but they carry a risk of significant side effects. Findings from this review must be interpreted with caution as studies were typically of low quality and most outcomes were based on a small number of studies. Further long-term, high-quality research is needed to determine the effectiveness and safety of psychotropic medication for reducing challenging behaviour.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-015-0688-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Pharmacological interventions for challenging behaviour in children with intellectual disabilities: a systematic review and meta-analysis

et al. 2015

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“…Psychoactive medications are widely used, in up to 60% of individuals with intellectual disability, for the treatment of behaviour (Holden & Gitlesen, ; Tsiouris, Kim, Brown, Pettinger, & Cohen, ). A recent review highlights prescribing medication ‘off‐label’ (Farmer & Aman, ) to treat behaviour rather than psychopathology. Despite the widespread use of psychoactive medication, evidence for the efficacy of these medications to reduce self‐injury is limited.…”

Section: The Use Of Medication As Treatment For Self‐injurymentioning

confidence: 99%

Practitioner Review: Self‐injurious behaviour in children with developmental delay

Oliver

Richards

2015

Child Psychology Psychiatry

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Behaviour dysregulation, as evidenced by the associations between self-injury, self-restraint, repetitive and impulsive behaviours, is identified as potentially influencing the severity and persistence of self-injury. Risk markers for self-injury are identified and the extended model indicates points of intervention and highlights the possibility of risk-related, targeted early intervention. The need for increased training of practitioners in the delivery of demonstrably effective interventions for self-injury is identified.

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“…through to seven (among the most severely ill patients) (Busner & Targum, 2007). The CGI measure has been utilized in similar populations to determine changes in child and adolescent behaviour (Farmer & Aman, 2013). parents handed in any remaining treatment, bottles, and diaries, and were reimbursed with a $50 cheque to assist with travel costs for attending the sessions, while participants were provided with a $50 book voucher and 3-months' supply of the CDRI 08 ® treatment.…”

Section: Clinical Global Impression Scalementioning

confidence: 99%

Effects of Bacopa monnieri (CDRI 08®) in a population of males exhibiting inattention and hyperactivity aged 6 to 14 years: A randomized, double‐blind, placebo‐controlled trial

Kean

Downey

Sarris

et al. 2022

Phytotherapy Research

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The current study investigated the efficacy of extract of Bacopa monnieri (BM; CDRI 08 ® ) in reducing levels of inattention and hyperactivity in young children. BM has demonstrated improvements in cognitive outcomes in adults, yet little research is available on its effects in younger populations. A 14-week randomized, double-blind, placebo-controlled clinical trial, with placebo run-in and run-out phases, investigated the effects of BM on behavioural, cognitive, mood, and sleep effects in male children aged 6 to 14 years against placebo. One-hundred and twelve participants were recruited into the trial, with 93 datasets available for analysis. No significant behavioural differences were noted between treatment groups. Cognitive outcomes indicated decreased error-making in children taking CDRI 08 ® (p = .04) and increased speed of reaction time in those taking placebo (p = .04) at study end. Improvements in cognitive flexibility (p = .01), executive functioning (p = .04), interpersonal problems (p = .02), and sleep routine (p = .04) were noted in those consuming CDRI 08 ® over placebo. CDRI 08 ® did not improve behavioural outcomes, but may have cognitive, mood and sleep benefits in children aged 6 to 14 years. Further study is required to support the findings presented here.

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Pharmacological Intervention for Disruptive Behaviors in Intellectual and Developmental Disabilities

Cited by 7 publications

References 120 publications

Pharmacological interventions for challenging behaviour in children with intellectual disabilities: a systematic review and meta-analysis

Pharmacological interventions for challenging behaviour in children with intellectual disabilities: a systematic review and meta-analysis

Practitioner Review: Self‐injurious behaviour in children with developmental delay

Effects of Bacopa monnieri (CDRI 08®) in a population of males exhibiting inattention and hyperactivity aged 6 to 14 years: A randomized, double‐blind, placebo‐controlled trial

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