Current prescribing preferences among relevant experts regarding the use of psychotropic medication for the management of behavior problems in adults with intellectual disabilities in the absence of a diagnosed psychiatric illness was defined. We used a questionnaire design to synthesize the preferences of a large group, namely, clinical…

Akathisia, a state of uncontrollable motor restlessness, is a side effect of neuroleptic treatment. The prevalence rate of akathisia in 94 adults with mental retardation was estimated to be 5% in neuroleptic-free subjects, 17% in neuroleptic-maintenance subjects, and 25% in neuroleptic-reduction subjects. Akathisia was also related to dyskinesia…

Donepezil, an acetycholinesterase inhibitor, or a placebo were given to 29 subjects with Down syndrome and no dementia. Measures of cognitive functioning and caregiver ratings indicated no improvement in any cognitive subtests (with the exception of language), behavioral scores, or caregiver ratings. Results suggest donepezil may improve language…

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)

Medicaid billing information was used to examine the administration of psychotropic medication to residents of community long-term care facilities providing mental retardation services. Results indicated 28.9 percent of such residents in Illinois received at least one psychotropic medication with little or no influence of demographic and facility…

The use of psychotropic medication with persons who have mental retardation was surveyed. Data were collected on a large sample of Oklahomans in both 1994 and 2000. Analysis revealed that the use of antidepressant medication increased dramatically over the course of the study, apparently as a function of increased use of SSRI medications.…

This study found a high incidence of nontraumatic fractures in adults with developmental disabilities living in a state-run facility, a 7.3% incidence among 391 adults. Factors associated with fractures included use of antiepileptic medication. Although bone mineral density (BMD) by heel ultrasound did not predict fracture, values were much lower…

Literature is reviewed and a case report is presented concerning blockers of the beta-adrenergic function of the sympathetic nervous system, postulated to have efficacy in treatment of aggressive or self-injurious syndromes in persons with mental retardation. Concerns are raised regarding endorsement of beta-blocking medications before they have…

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…

Psychotropic drug-prescribing patterns for 474 adults with mental retardation residing at an intermediate-care facility were examined for a 10-year period. Results indicated a progressive, marked decrease in total psychotropic drug usage and changes in the type of drugs prescribed with overall decline in drug usage. (Author/DB)

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.…

Neuroleptic-induced akathisia is a relatively common side effect of neuroleptic medication, characterized by a subjective sense of restlessness; the inability to sit still; and sometimes aggression, anxiety, sleep disturbance, and suicide. The importance of the diagnosis and treatment of neuroleptic-induced akathisia in individuals with mental…

Neuroleptic malignant syndrome, an uncommon but potentially lethal complication of antipsychotic medication, is reviewed, including analysis of 29 cases in which the condition appeared in individuals with mental retardation. Recommendations about reducing morbidity and mortality in this population are offered. (Author/DB)

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…

The efficacy of the atypical antipsychotic risperidone was evaluated in the treatment of aberrant behavior (e.g., aggression, self-injury) in 20 individuals with developmental disabilities. The study, a double-blind crossover design, identified 50 percent of participants as responders. Naturalistic observations of five participants showed that…