Practitioner Review: Psychopharmacology in children and adolescents with mental retardation

Handen, Benjamin L.; Gilchrist, Richard

doi:10.1111/j.1469-7610.2006.01588.x

Cited by 82 publications

(60 citation statements)

References 74 publications

(131 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The prevalence rate of ADHD in the general population is 5%, (18) and between 9% to 16% in the paediatric population with an ID (19). The long-term impact of ADHD is significant in children with an ID, and can result in anxiety, aggression and social ostracism problems, especially in adolescents (20).…”

Section: Intellectual Disability and Adhdmentioning

confidence: 99%

“…Response rates vary between 45% to 66% in the population with an ID, versus 77% in the population without an ID (19), with benefits including decreased impulsivity, inattention and hyperactivity, in both classroom and leisure activities.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

“…Methylphenidate (MPH) has been the most extensively studied medication used in children with an ID and ADHD, with 20 double-blind, placebo-controlled studies conducted through 2006 (19). Response rates vary between 45% to 66% in the population with an ID, versus 77% in the population without an ID (19), with benefits including decreased impulsivity, inattention and hyperactivity, in both classroom and leisure activities.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

“…The usual recommendation is to try two different stimulants before considering other options, such as atomoxetine (19). Alpha agonists, such as clonidine and guanfacine, are also used.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

“…The long-term impact of ADHD is significant in children with an ID, and can result in anxiety, aggression and social ostracism problems, especially in adolescents (20). Detailed reviews of the topic of ADHD and ID are available (19).…”

Section: Intellectual Disability and Adhdmentioning

confidence: 99%

See 4 more Smart Citations

Behaviour disorders in children with an intellectual disability

Ageranioti-Bélanger

Brunet

D’Anjou

et al. 2012

Paediatrics &Amp; Child Health

View full text Add to dashboard Cite

T he diagnosis of an intellectual disability (ID) relates to a heterogeneous group of individuals, approximately 3% of the population, whose intelligence quotient is <70. Behaviour disorders are frequent in children with an ID, can create problems in everyday life and can mask, or reveal an organic or psychiatric illness. It is crucial to adopt a multidisciplinary approach in treating these behaviours.In the present review, we first describe some general concepts dealing with the management of behaviour disorders in children with an ID, and then provide an overview of, in our experience, the four most common of these disorders: sleep disturbances, agitation (as it relates to attention-deficit hyperactivity disorder [ADHD]), aggression and self-injury. The treatment of organic problems and psychiatric illnesses that may cause behaviour disorders is beyond the scope of the present article. The present article is based on a conventional and complete literature review, with many of the practical suggestions based on the experience of the authors (ie, group consensus). General concepts assessmentThe first step is to obtain an adequate medical history including onset of the behaviour disorder, evolution over time, extenuating or aggravating factors (eg, environmental stressors that could be impacting the child), functional impairment, a family history of psychiatric problems and the impact of the child's behavioural difficulties on other family members. It is also important to have information on the individual's level of functioning including cognitive, adaptive, social-functioning, levels of receptive understanding and expressive language (1). A thorough physical examination is required in all cases.In cases where parents or tutors 'no longer recognize the child' and there are, for example, autonomic symptoms such as loss of appetite combined with a loss of weight or marked changes in sleep habits, a specific questionnaire dealing with psychiatric symptoms must be completed. A family history of depression, loss of interest in favourite activities, evidence of sadness and recent irritability should suggest the possibility of a depression. In investigating a possible anxiety problem, it is important not only to consider the family history, but also the avoidance of specific situations, difficulties with transitions, difficulties encountered in distancing oneself from attachment figures or the presence of adrenergic symptoms (eg, tachycardia, tremor) during a crisis. A bipolar illness must be considered in the presence of a family history or severe agitation cycles alternating with periods of apathy.In most circumstances, a suspected psychiatric etiology would require evaluation and management by a child psychiatrist. The prevalence rate of psychiatric disturbances, in the population of children with an ID, is 20% to 35%, that is, three to five times higher than that for the general population. It is important to rule out the possibility of a psychiatric disturbance when the patient shows behavioural symptoms of recent...

show abstract

Section: Intellectual Disability and Adhdmentioning

confidence: 99%

Section: Pharmacological Treatmentmentioning

confidence: 99%

Section: Pharmacological Treatmentmentioning

confidence: 99%

“…The usual recommendation is to try two different stimulants before considering other options, such as atomoxetine (19). Alpha agonists, such as clonidine and guanfacine, are also used.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Section: Intellectual Disability and Adhdmentioning

confidence: 99%

See 3 more Smart Citations