A Review of Empirical Evidence of Somatic Treatment Options for the MI/DD Population

Abstract

This article reviews recent evidence in the literature for the use of psychotropic and other somatic treatments in the management of patients with mental retardation (MR). The search methodology included peer-reviewed English language publications in PubMed and PsychINFO with the words Mental Retardation, Intellectual Disability, Developmental Disability and Mental Disorders/Drug Therapy or Antipsychotic medications, Psychiatric Somatic therapies, Neuroleptic Drugs, Antidepressants and Electroconvulsive Therapy from 1998 to 2008. The review revealed few randomized controlled trials on the medications frequently prescribed for patients with MR. Three RCTs of Risperidone in children, one combining adults and children and one with adults only are discussed. There was one RCT involving Quetiapine and one on Citalopram. There is little evidence to support the scope of psychotropic medication use in the MR population though the field is advancing. The contribution of psychiatric illness to challenging behaviors is not systematically addressed in the literature.

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

“…); pharmacological treatment of bipolar disorder in children and adolescents (Gutkovich & Carlson ); pharmacological management of inappropriate sexual behaviours (Sajith et al . ); and somatic treatment of psychiatric and behavioural problems, including psychotropic medication and electroconvulsive therapy (Ulzen & Powers ). These reviews are summarized in Table Section I.…”

Neurodevelopmental and psychiatric issues in Down’s syndrome

“…Reviews on this topic suggest that individuals with ID respond similar to the TD population to various psychotropic medications (Handen and Gilchrist, 2006;Ulzen and Powers, 2008). Reviews on this topic suggest that individuals with ID respond similar to the TD population to various psychotropic medications (Handen and Gilchrist, 2006;Ulzen and Powers, 2008).…”

Psychiatric Services for Individuals with Intellectual and Developmental Disabilities: Medication Management

“…Are these medications overused because of the lack of availability of behavioral services in the community? Second, the evidence for the efficacy of these medications in treating disruptive, aggressive, and self-injurious behavior in both children and adults is incomplete and mixed Sohanpal et al, 2007;Ulzen & Powers, 2008). Third, there is an increased awareness that second-generation antipsychotic medications are associated with a number of significant short-and long-term side effects, including weight gain, metabolic syndrome, endocrine effects, cardiac effects, and sedation (Correll, 2008b).…”

“…Although the use of psychiatric medications in the population with IDD is widespread across ages and settings-institutional, community, and home (B. Holden & Gitlesen, 2004;Matson & Neal, 2009;Olfson, Crystal, Huang, & Gerhard, 2010;Spreat, Conroy, & Fullerton, 2004)-relatively limited efficacy data is available Sohanpal, Deb, Thomas, Soni, Lenotre, & Unwin, 2007;Ulzen & Powers, 2008). Concerns about the quality of medication practices in persons with IDD have been raised, including prescription without a corresponding psychiatric diagnosis or assessment (B.…”