Withdrawal of Chronic Chlorpromazine Medication: An Experimental Analysis

Abstract

Approximately 50% of all institutionalized, mentally retarded adults receive psychotropic medication to control inappropriate behavior. In this study, behaviors exhibited by five retarded adults were formally observed while they were on and off medication. Each subject had been receiving chlorpromazine for six or more years prior to the start of the study. The drug was withdrawn and readministered using a double-blind B-A-B (drug placebo-drug) design. Effects were highly individualized. Some desirable behavior emerged when chlorpromazine was discontinued.

Use of Psychotropic Drugs by Mentally Retarded Adults in Community Programs

“…Breun ing et al's. findings were consistent with those of Marholin et al (1979), who noticed no general benefits in workshop and ward behaviors among five residents receiving chlorpromazine. Davis, Poling, Wysocki, & Breuning (in press) demonstrated that phenytoin (Dilantin) had a signifi cant effect on cognitive and workshop performance.…”

“…Psychotropic drug use with mentally retarded in dividuals has been associated with impairments in pro duction and learning tasks (Breuning & Davidson, 1981;Breuning, O'Neill, & Ferguson, 1980;Hartlage, 1965;Hollis & St. Omer, 1972;Marholin, Touchette, & Stewart, 1979;Wysocki, Fuqua, Davis, & Breun ing, 1981;Breuning et al, Note 1). Though these studies have examined drug effects in institutional set tings, their finding may suggest that drugs have similar deleterious effects in community settings.…”

Multidisciplinary Assessment and Treatment of Self-Injurious Behavior in Autism Spectrum Disorder and Intellectual Disability: Integration of Psychological and Biological Theory and Approach

“…A subsequent investigation reported the drug as ''helpful'' for 5 of 6 individuals with severe ID and SIB, but the study was unblinded and involved treatment with multiple drugs (Gualtieri and Schroeder 1989). Chlorpromazine, a low potency D 2 blocker with moderate 5-HT effects, has shown no consistent effects on SIB, and studies that have shown ''improvements'' did not utilize objective measures (Adamson et al 1958;Aman 1993;Marholin et al 1979;Miyamoto et al 2002;Zhang and Bymaster 1999). Thioridazine, another low potency D 1 and D 2 antagonist, was not found to be efficacious for SIB in multiple studies (Aman and White 1988;Davis et al 1969;Singh and Aman 1981;Svendsen et al 1988).…”

Clinical Behavioral Pharmacology: Methods for Evaluating Medications and Contingency Management

“…One reason is that many drugs have serious side effects (Levenson, 1981). Neuroleptics have been associated with tardive dyskinesia and adverse effects on learning and performance (Aman & Singh, 1980;Marholin, Touchette, & Stewart, 1979;Sprague, Barnes, & Werry, 1970; Wysocki, Fuqua, Davis, & Breuning, 1981), and stimulant medications can cause insomnia, weight loss, and possible depression of growth rate in children (Walker, 1982).…”