Pharmacotherapy of disruptive behavior in mentally retarded subjects: A review of the current literature

Abstract

The review presented here describes the state of the art of pharmacological treatment of aggression in subjects with mental retardation (MR) summing up results for both, children and adults. In general, psychopharmacological treatment of disruptive behavior in individuals with MR is similar to the treatment in subjects without MR. Compared to individuals without MR medication should "start lower and go slower." For children and adults results were similar but were obtained by somewhat different medications. There is evidence for the conventional antipsychotic zuclopenthixol having positive effects on disruptive behavior. Most studies described the atypical antipsychotic risperidone to control severe self-injurious behavior and other behavior problems in a variety of diagnoses. Anticonvulsants, antidepressants, and anxiolytic medications are reported as effective as well for the treatment of individuals with disruptive behavior. Aggression-related behavior often gets treated with stimulants or with stimulants combined with atypical neuroleptics.

Improvement of nonsuicidal self-injury following treatment with antipsychotics possessing strong D1 antagonistic activity: evidence from a report of three cases

“…Thus, to the best of the authors' knowledge, the case series presented here is the second clinical paper suggesting a role for strong D1 antagonists in NSSI drug therapy and for the D1 receptor in the pathogenesis of NSSI in humans. Interestingly, and in accordance with our here-presented findings, ZPT has been described to effectively reduce auto-aggressive behavior in mentally retarded patients [Häßler and Reis, 2010], but however, has, to the best of our knowledge, hitherto not been shown to reduce auto-aggression in patients without mental retardation. The fact that our results are also in agreement with findings in rodents -for example, the synthetic D1 receptor antagonist SCH23390 effectively alleviated self-injury in 6-hydroxydopamine lesioned rats [Sivam, 1989] -further supports the role of D1 receptors in the pathogenesis of NSSI.…”

Use of Antipsychotic Medications in Pediatric Populations: What do the Data Say?

“…Such uses include (but are not limited to): sleep disorders, Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, Major Depressive Disorder, and Post-Traumatic Stress Disorder. SGAs are also prescribed to individuals with developmental delay to treat aggression and self-injurious behaviors [15-18]. Lack of FDA approval stems in part from the ethics of protecting vulnerable populations from clinical trials research during drug development.…”

Effectiveness of long-acting risperidone in a patient with comorbid intellectual disability, catatonic schizophrenia, and oneiroid syndrome

“…Risperidone has been used successfully to treat catatonic symptoms, 6 mental retardation, 7 and related maladaptive behaviors. 8 This case showed LAR efficacy in a patient with comorbid mental retardation and catatonic schizophrenia. After receiving LAR injections, our patient showed a rapid improvement of catatonic symptoms, followed suit by remission of oneiroid symptoms.…”