Beta-adrenergic blockers in mental retardation and developmental disabilities

Recent research on aetiology, development and phenomenology of self‐injurious behaviour in people with intellectual disabilities: a systematic review and implications for treatment

“…2011) with behavioural intervention, for example by using such medications to assist in controlling arousal during graduated exposure. Ruedrich & Erhardt (1999) suggested that following investigations for risk factors for their use, beta‐adrenergic blockers might be useful in controlling situational anxiety in some people with IDs. In cases of SIB involving SAM overreactivity (Symons et al .…”

“…The respondent/ operant model may therefore also provide a basis for integrating psychopharmacological treatment using adrenergic attenuating drugs ) with behavioural intervention, for example by using such medications to assist in controlling arousal during graduated exposure. Ruedrich & Erhardt (1999) suggested that following investigations for risk factors for their use, beta-adrenergic blockers might be useful in controlling situational anxiety in some people with IDs. In cases of SIB involving SAM overreactivity ), short-term use of these medications during graduated exposure interventions might disrupt associations between environmental stimuli and heightened arousal, thereby extinguishing (via Pavlovian processes) the ability of those stimuli to elicit SIB.…”

From Research to Practice: Toward the Examination of Combined Interventions for Autism Spectrum Disorders

“…Adrenergic agents have also been reported to reduce severe aggressive and self-injurious behaviors in people with ASD [45][46][47]. Most of the literature consists of case studies, although there have been several small double-blind, placebo-controlled studies involving patients with these symptoms [48]. These studies involved many different psychiatric diagnoses, including intermittent explosive disorder among people with various types of intellectual disabilities with various etiologic origins [49].…”

Biological Treatment of Asperger'sDisorder

“…Although beta-adrenergic medications have been hypothesized to benefit persons with a wide variety of neuropsychiatric disorders, research supports their use in only three areas-anxiety disorders with prominent physiological signs, neuroleptic-induced akathisia, and impulsive aggression (24). Small case reports and pilot trials have suggested benefits on aggression and selfinjurious behavior in the autistic population, however, most studies looked at benefits in individuals with some form of cognitive delay, often moderate-tosevere mental retardation (25,26).…”

“…There is some consensus that betablockers are best used adjunctively and are generally not efficacious as monotherapy. Of additional interest is the suggestion by some clinicians that nadolol, a hydrophilic beta-blocker, may be preferable for anxiety symptoms, whereas propranolol and metoprolol (both of which are lipophilic) are more beneficial in treating aggression (24). Irregardless, until further studies including individuals with Asperger syndrome, or even "high-functioning" autism, are undertaken, it is difficult to suggest the use of this class of medications as first-line treatment.…”