Assessing the impact of psychotropic medication changes on challenging behavior of individuals with intellectual disabilities

Abstract

Objective The use of psychotropic medication to address challenging behavior in individuals diagnosed with intellectual disabilities is common practice; however, very few studies have examined how multiple medication use (or combination treatment) impacts the behaviors these medications are prescribed to treat. Method The current study followed eight individuals over a two-year period as they experienced changes in their psychotropic medication regimens. During that time, data from functional analyses and indirect assessments of challenging behavior were collected. Results The results suggest that changes in psychotropic medication regimens can produce changes in functional assessment outcomes, suggesting a need for continued behavioral assessment to better inform medication practices and behavioral treatment. Of the eight participants in the study, five participants’ behaviors varied in rate of responding in FAs across all medication changes. Additionally, three participants’ FAs produced changes in outcomes; however, those changes were not consistent across all medication changes, that is, not every medication change yielded different outcomes from previous assessments. Conclusion This study demonstrates how the outcome of an FA can be used to monitor the effects of psychotropic medication changes, specifically when medications are combined, on challenging behavior in individuals with intellectual and developmental disabilities.

Treatment algorithm for the use of psychopharmacological agents in individuals prenatally exposed to alcohol and/or with diagnosis of fetal alcohol spectrum disorder (FASD)

“…The panel of experts endorsed the FAC's concerns that individuals with ND-PAE/FASD, and their caregivers, experience inordinate stress from complications of high dose multiple psychotropic medications. 5,8 Noting the positive role of psychosocial interventions in other neurodevelopmental conditions, 9 experts recommended the rational use of psychotropic medications after first establishing family, psychosocial, and community supports. In recommending an ND-PAE/ FASD-specific treatment algorithm, the experts reasoned that individuals with ND-PAE/FASD compared to neurotypical patients have neuronal wiring challenges that respond differently to psychotropic medications, many of which are based on ligand-specific receptors.…”

Characterizing Mood States in Individuals Diagnosed with Bipolar Disorder and Intellectual Disability

“…As part of a larger study (see Valdovinos et al, 2016), all participants were observed once a week with the day of week and time held constant. Ross was observed for a total of 46 observations over a 15-month period.…”

Long‐term functional stability of problem behavior exposed to psychotropic medications

“…Then, they drew tentative conclusions suggesting that medication adjustments appeared to impact both rate and function of problem behavior. Despite the apparent utility of the method, studies employing it have primarily monitored the effects of medication adjustments by conducting relatively few FA sessions within and across medication phases (Dicesare et al, 2005; Valdovinos et al, 2016). For example, Valdovinos et al (2016) conducted the most recent study evaluating medication adjustment impact across eight participants using brief FAs.…”

“…Despite the apparent utility of the method, studies employing it have primarily monitored the effects of medication adjustments by conducting relatively few FA sessions within and across medication phases (Dicesare et al, 2005; Valdovinos et al, 2016). For example, Valdovinos et al (2016) conducted the most recent study evaluating medication adjustment impact across eight participants using brief FAs. In this study, three of the eight participants showed function‐specific effects.…”