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Antipsychotics Don't Curb Aggressive Behaviors

Antipsychotics should not be used to treat behavior disturbance associated with intellectual disability

FRIDAY, Jan. 4 (HealthDay News) -- Though commonly used with the goal of curtailing aggressive behaviors in intellectually disabled individuals, antipsychotic drugs may actually be inferior to placebo at reducing aggression and should no longer be recommended, according to the results of a randomized trial published in the Jan. 5 issue of The Lancet.

Peter Tyrer, of Imperial College in London, U.K., and colleagues randomly assigned 86 non-psychotic, intellectually disabled patients with aggressive challenging behavior to receive treatment with haloperidol, risperidone or placebo. The primary outcome was a change in aggression after four weeks of treatment, measured with the modified overt aggression scale (MOAS).

After four weeks of treatment, aggression decreased substantially in all groups, with the greatest change in the placebo group. MOAS scores decreased in the placebo group by 79 percent from baseline compared to 58 percent for risperidone and 65 percent for haloperidol. Treatment compliance was high, with most patients adhering to 80 percent or greater to the prescribed drug.

Though the authors allow that antipsychotics may still have a role in the treatment of some aggressive behaviors associated with intellectual disability, such as in autistic behavior disturbances, they nonetheless "conclude that the routine prescription of antipsychotic drugs early in the management of aggressive challenging behavior, even in low doses, should no longer be regarded as a satisfactory form of care."

Medication in this trial was provided by Janssen-Cilag.

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