This reaction paper reviews a report on the use of carbamazapine for behavioral disorders. The paper translates the original report's data into percentages and concludes that carbamazapine has a more limited role in behavior disorder treatment. The original report's author then clarifies various points criticized in the reaction paper. (JDD)

The incidence of medical and behavioral symptoms that could occur as side effects of psychotropic medication was assessed in a sample of 30 adults with developmental disabilities. Using a retrospective chart review method, we measured symptoms in six a priori classes of potential side effects over a 2-year period. The majority of side effects…

The efficacy of the serotonin uptake inhibitor clomipramine in treating stereotyped and related repetitive behavior disorders was tested in 10 adults (ages 18-42) with severe and profound mental retardation. Of the seven participants who tolerated the drug, six exhibited a clinically significant improvement in one or more repetitive behaviors.…

Four adults with severe/profound mental retardation and self-injurious behavior (SIB) received naltrexone in a double-blind procedure. All patients exhibited decreased SIB when treated with naltrexone; three patients decreased SIB as naltrexone dose increased. There were no consistent effects of naltrexone on stereotypy, activity, or performance…

This study investigated whether blood plasma levels of pro-opiomelanocortin-derived (POMC) peptides, beta-endorphin-like activity, adrenocorticotrophic hormone, and adrenal cortisol immediately after self injurious behavior (SIB) episodes predicted subsequent response to an opiate blocker in 10 patients with mental retardation. Results suggest…

The last in seven sets of guidelines based on the consensus of experts in the treatment of psychiatric and behavioral problems in mental retardation (MR) focuses on medication dosing. The guidelines cover classes of medication, specific medications, usual starting daily dose, and usual daily dose range. (DB)

Severely and profoundly mentally retarded institutionalized residents (N=74) who received lithium carbonate for behavior disorders were followed in a 10-year retrospective study. Thirty-one subjects demonstrated a sustained major reduction or elimination of behavioral symptoms. Lithium responders were likely to be older and to present symptoms of…

Ten adults with compulsive behavior disorder and six comparison subjects, all with mental retardation, were treated using the medication fluoxetine. Seven of the 10 experimental subjects responded favorably to fluoxetine treatment; none of the comparison subjects responded favorably to the medication. There appeared to be a relation between…

The sixth in seven sets of guidelines based on expert consensus in the treatment of psychiatric and behavioral problems in mental retardation (MR) focuses on managing inadequate response to initial medication treatment. Guidelines cover recommended steps before changing the medication regimen and selecting the next medication or adjunctive…

Eight young adults (ages 19-39) with autism were given the opiate antagonist naltrexone to control self-injurious behavior and maladaptive idiosyncratic mannerisms. Although one subject appeared to have partial decreases in maladaptive behaviors, the drug did not clearly reduce the self-injurious and other maladaptive behaviors of the subjects.…

Records covering a five-year period of adults with mental retardation in a residential program were reviewed to determine differences in antipsychotic dosages over time. Findings suggest that individuals with mental retardation who do not have psychoses are a suitable group for dosage reduction and that use of alternative medications facilitates…

The fourth in seven sets of guidelines based on the consensus of experts in the treatment of psychiatric and behavioral problems in mental retardation (MR) focuses on medication treatment. Guidelines cover strategies of medication management, when to include a medication in the initial treatment plan, and reasons for long-term medication…

The fifth in seven sets of guidelines based on the consensus of experts in the treatment of psychiatric and behavioral problems in mental retardation (MR) focuses on selection of medications. Guidelines cover selection of medications for psychiatric disorders, selection of medications for target symptoms, and preferred medications within different…

The effect of neuroleptic withdrawal on postural task performance of 20 adults with mental retardation was examined. Assessments were conducted at baseline and monthly intervals, extending to one year following complete medication withdrawal, when significant changes in amount of postural motion and sequential pattern of postural movement…

Fifty-eight tables provide a breakdown of answers to a survey responded to by 45 experts in the medication treatment of psychiatric and behavioral problems in people with mental retardation. Questions address treatment of specific disorders, ratings of various medications for specific disorders or symptoms, and preferences in mood stabilizers,…