Efficacy of Atypical Antipsychotic Medication in the Management of Behaviour Problems in Children with Intellectual Disabilities and Borderline Intelligence: A Systematic Review

University of Birmingham, School of Psychology, Birmingham, UK.
Research in developmental disabilities (Impact Factor: 4.41). 08/2011; 32(6):2121-33. DOI: 10.1016/j.ridd.2011.07.031
Source: PubMed


The use of medications to manage problem behaviours is widespread. However, robust evidence to support their use seems to be lacking. The aim was to review research evidence into the efficacy of atypical antipsychotic medication in managing problem behaviour in children with intellectual disabilities and borderline intelligence. A systematic review was conducted for placebo-controlled randomised double-blind trials. The included studies (N = 6) showed that risperidone was significantly more effective than placebo in managing problem behaviours. However, most studies highlighted adverse events primarily somnolence and weight gain. There is now some evidence in favour of the use of risperidone. However, because of possible adverse events, these medications have to be used with caution.

Download full-text


Available from: Gemma Unwin, Oct 15, 2015
  • Source
    • "Another problem with lithium prescribing is that in some people with severe ID it may not be possible to carry out recommended blood tests. A prospective 12 months follow-up study found little evidence of use of lithium in ID by UK psychiatrists (Unwin et al., 2011). There is not as yet much evidence for the effectiveness of other mood stabilizers such as sodium valproate, carbamazepine, and lamotrigine, which may provide a better alternative to lithium. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This review of research into mental disorders in people with intellectual disabilities (ID) focuses on research in this field that has originated from the United Kingdom in the last 2 decades. It considers research developments into the epidemiology of mental disorders and problem behaviors, psychopharmacology, psychosocial interventions, and services for people with ID.
    Journal of Mental Health Research in Intellectual Disabilities 04/2013; 6(2):127-158. DOI:10.1080/19315864.2012.708100
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe the relationship between mental health diagnosis and treatment with antipsychotics among U.S. Medicaid-enrolled children over time. Medicaid Analytic Extract (MAX) files for 50 states and the District of Columbia from 2002 to 2007. Repeated cross-sectional design. Using logistic regression, outcomes of mental health diagnosis and filled prescriptions for antipsychotics were standardized across demographic and service use characteristics and reported as probabilities across age groups over time. Center for Medicaid Services data extracted by means of age, ICD-9 codes, service use intensity, and National Drug Classification codes. Antipsychotic use increased by 62 percent, reaching 354,000 youth by 2007 (2.4 percent). Although youth with bipolar disorder, schizophrenia, and autism proportionally were more likely to receive antipsychotics, youth with attention deficit hyperactivity disorder (ADHD) and those with three or more mental health diagnoses were the largest consumers of antipsychotics over time; by 2007, youth with ADHD accounted for 50 percent of total antipsychotic use; 1 in 7 antipsychotic users were youth with ADHD as their only diagnosis. In the context of safety concerns, disproportionate antipsychotic use among youth with nonapproved indications illustrates the need for more generalized efficacy data in pediatric populations.
    Health Services Research 09/2012; 47(5):1836-60. DOI:10.1111/j.1475-6773.2012.01461.x · 2.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose ‐ The purpose of this article is to explore the current evidence base in understanding the relationship between mental health and challenging behaviour in people with intellectual disabilities. Design/methodology/approach ‐ The article discusses how challenging behaviour is associated with psychiatric disorders. Common aetiological factors between challenging behaviour and psychiatric disorders and diagnostic issues are considered. The article ends with a review of the assessment and management of challenging behaviour within the context of mental health. Findings ‐ Several studies have highlighted common aetiological factors that are responsible for challenging behaviour and psychiatric disorders in people with intellectual disabilities, and although there is an overlap in the symptoms, both are thought to be different phenomena. Treatment of the psychiatric disorder should ameliorate the challenging behaviour, although a functional analysis of the behaviour may still be required in order to understand the purpose of the behaviour. There is evidence for a range of different treatment approaches. Originality/value ‐ The article will assist professionals working with people with intellectual disabilities to understand the complex relationship between mental health and challenging behaviour. It also gives guidance on principles of management of people with complex mental health and behavioural needs.
    09/2012; 6(5). DOI:10.1108/20441281211261131
Show more