Risperidone for attention-deficit hyperactivity disorder in people with intellectual disabilities

Abstract

There is no evidence from RCTs that risperidone is effective for the treatment of ADHD in people with ID. Prescribing in this population can only be based on open-label studies or extrapolation from research in people with autism and disruptive behaviour disorders; however these studies have not investigated people with ID separately so there are reservations regarding the applicability of these findings. Research into effectiveness and tolerability is urgently needed.

Systematic Reviews of the Health or Health care of People with Intellectual Disabilities: A Systematic Review to Identify Gaps in the Evidence Base

“…These are summarized in Table 1. Of these nine 'empty reviews', five were concerned with pharmacological interventions in relation to mental and behavioural disorders (Duggan & Brylewski 2004;Mohan et al 2009a,b,c;Thomson et al 2009b). One was concerned with RCTs of both pharmacological and non-pharmacological interventions for sex offenders with intellectual disability (Ashman & Duggan 2008).…”

“…Mohan et al (2009b) Memantine for AD in people with DS Start dates from 1872 to October 2008 Inclusion: RCTs (including cross-over studies) of participants with AD in DS in which treatment with memantine was administered for more than a day and compared with a placebo group; any age, diagnosed with dementia using standardized instruments. Thomson et al (2009b) Risperidone for attention-deficit hyperactivity disorder (ADHD) in people with intellectual disabilities Any start date to February 2009 All RCTs including cluster randomization or a cross-over design, both published and unpublished, in any language, in which children or adults with ADHD and intellectual disabilities were treated with risperidone compared to placebo. Exclusion: participants with uncontrolled epilepsy, comorbid psychotic illness or a history of head injury.…”

Interventions for adults with mild intellectual disabilities and mental ill‐health: a systematic review

“…A previous systematic review in 1999 on antipsychotics for people with intellectual disabilities and schizophrenia found only one randomised control trial (RCT), with a sample size of 4 (Duggan & Brylewski 1999). Another systematic review on risperidone for people with intellectual disabilities and ADHD found no suitable RCTs (Thomson et al 2009). The lack of evidence (lack of studies) does not seem to deter prescription -30-50% of people with intellectual disabilities are prescribed psychotropic medication (Kuijper et al 2010;Tyrer et al 2014).…”

A meta‐analysis of intervention effects on challenging behaviour among persons with intellectual disabilities

“…Treatment strategies that are frequently employed are biological and psychotherapeutic interventions, sometimes supplemented with contextual strategies (Bouras 1999;Ager & O'May 2001;Dösen & Day 2001;Gavidia-Payne & Hudson 2002;Kahng et al 2002;Taylor 2002;Grey & Hastings 2005;Benson & Brooks 2008;Mildon et al 2008). Recently, some reviews and meta-analytic articles have studied these interventions for challenging behaviour among persons with ID (Brylewski & Duggan 1999;Prout & Nowak-Drabik 2003;Shogren et al 2004;Didden et al 2006;Lotan & Gold 2009;Matson & Neal 2009;Thomson et al 2009aThomson et al , 2009b. None of these articles included both the biological and the psychotherapeutic and contextual interventions, although it is interesting to compare effects of these three intervention types, either applied alone or combined, with each other.…”