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Neuroleptic Medications for Persons with Developmental Disabilities

  • Stephen R. Schroeder
Part of the Disorders of Human Learning, Behavior, and Communication book series (HUMAN LEARNING)

Abstract

Since the many methodological reviews of the early 1980s, there have been a number of neuroleptic studies with persons who have developmental disabilities. Generally these recent studies are better designed, with multimodal assessment packages and double-blind placebo controls. Prospective studies tend to support the view that low doses of neuroleptics may inhibit inappropriate behaviors, especially stereotypy, to a modest degree and may promote learning in some cases, whereas high doses tend to produce untoward effects. However, the results so far present a very incomplete mosaic of findings, and much more systematic research is required before firm conclusions can be reached.

Keywords

Developmental Disability Tardive Dyskinesia Stereotyped Behavior Neuroleptic Malignant Syndrome Brief Psychiatric Rate Scale 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Alexandris, A., & Lundell, F.W. (1986), Effect of thioridazine, amphetamine, and placebo on the hyperkinetic syndrome and cognitive area in mentally deficient children. Canadian Medical Association Journal, 98, 92–96.Google Scholar
  2. Aman, M.G. (1983). Psychoactive drugs in mental retardation. In J.L. Matson & F. Andrasik (Eds.), Treatment issues and innovations in mental retardation (pp. 455–513 ). New York: Plenum Press.Google Scholar
  3. Aman, M.G. (1984). Drugs and learning in mentally retarded persons. In G.D. Burrows & J.S. Werry (Eds.), Advances in human psychopharmacology (Vol. 3, pp. 121–163 ). Greenwich, CT: JAI Press.Google Scholar
  4. Aman, M.G., & Singh, N.N (1986). A critical appraisal of recent drug research in mental retardation: The Coldwater studies. Journal of Mental Dificiency Research, 30, 203–216.Google Scholar
  5. Aman, M.G., & Singh, N.N. (1980). The usefulness of thioridazine for treating childhood disorders-Fact or folklore? American Journal of Mental Deficiency, 84, 331–338.PubMedGoogle Scholar
  6. Aman, M.G., Singh, N.N., Stewart, A.W., & Field, C.J. (1985). The Aberrant Behavior Checklist: A behavior rating scale for measurement of treatment effects. American Journal of Mental Deficiency, 89, 485–491.PubMedGoogle Scholar
  7. Aman, M.G., Teehan, C.J., White, A.J., Turbott, S.H., & Vaithianathan, C. (in press). Haloperidol treatment with chronically medicated residents: Dose effects on clinical behavior and reinforcement contingencies. American Journal of Mental Retardation.Google Scholar
  8. Aman, M.G., & White, A.J. (1986). Measures of drug change in mental retardation. In K.D. Gadow (Ed.), Advances in learning and behavioral disabilities (Vol. 5 ). Greenwich, CT: JAI Press, pp. 157–202.Google Scholar
  9. Aman, M.G., White, A.J., & Field, C.J. (1984). Chlorpromazine effects on stereotypic and conditioned behavior-A pilot study. Journal of Mental Deficiency Research, 28, 253–260.PubMedGoogle Scholar
  10. Anderson, L.T., Campbell, M., Grega, D.M., Perry, R., Small, A.M., & Green, W.H. (1984). Haloperidol in the treatment of infantile autism: Effects on learning and behavioral symptoms. American Journal of Psychiatry, 141, 1195–1202.PubMedGoogle Scholar
  11. Barron, J., & Sandman, C.A. (1983). Relationship of sedative-hypnotic response to self-injurious behavior and stereotypy by mentally retarded clients. American Journal of Mental Deficiency, 88, 177–186.PubMedGoogle Scholar
  12. Breese, G.R., Mueller, R.A., & Schroeder, S.R. (1986). The neurochemical basis of symptoms in the Lesch-Nyhan syndrome: Relationship to control symptoms in other developmental disorders. In E. Schopler (Ed.), Current neurobiological issues in autism. New York: Academic Press. pp. 145–156.Google Scholar
  13. Breuning, S.E. (1982). An applied dose-response curve of thioridazine with the mentally retarded: Aggressive, self-stimulatory, intellectual and workshop behaviors-A preliminary report. Psychopharmacology Bulletin, 18, 57–59.PubMedGoogle Scholar
  14. Breuning, S.E., & Davidson, N.A. (1981). Effects of psychotropic drugs on intelligence test performance of institutionalized mentally retarded adults. American Journal of Mental Deficiency, 85, 575–579.PubMedGoogle Scholar
  15. Breuning, S.E., Davis, V.J. Matson, J.L., & Ferguson, D.G. (1982). Effects of thioridazine and withdrawal dyskinesias on workshop performance of mentally retarded young adults. American Journal of Psychiatry, 139, 1447–1454.PubMedGoogle Scholar
  16. Breuning, S.E., Davis, V.J., & Poling, A.D. (1982). Pharmacotherapy with the mentally retarded: Implications for clinical psychologists. Clinical Psychology Review, 2, 79–114.CrossRefGoogle Scholar
  17. Breuning, S.E., Ferguson, D.G., Davidson, N.A., & Poling, A.D. (1983). Effects of thioridazine on the intellectual performance of mentally retarded drug responders and nonresponders. Archives of General Psychiatry, 40, 309–313.PubMedGoogle Scholar
  18. Breuning, S.E., O’Neill, J., & Ferguson, D.G. (1980). Comparison of psychotropic drug, response cost, and psychotropic drug plus response cost procedures for controlling institutionalized retarded persons. Applied Research in Mental Retardation, 1, 253–168.PubMedCrossRefGoogle Scholar
  19. Campbell, M., Anderson, L.T., Meier, M., Cohen, I.L., Small, A.M., Samit, C., & Sachar, E.J. (1978). A comparison of haloperidol and behavior therapy and their interaction in autistic children. Journal of the American Academy of Child Psychiatry, 17, 640–655.PubMedCrossRefGoogle Scholar
  20. Campbell, M., Anderson, L.T., Small, A.M., Perry, R., Green, W.H., & Caplan, R. (1982). The effects of haloperidol on learning and behavior in autistic children. Journal of Autism and Developmental Disorders, 12, 167–176.PubMedCrossRefGoogle Scholar
  21. Caroff, S.N. (1982). The neuroleptic malignant syndrome. Journal of Clinical Psychiatry, 41, 79–83.Google Scholar
  22. Carter, G. (1983). The abrupt withdrawal of antiparkinsonian drugs in mentally handicapped patients. British Journal of Psychiatry, 142, 166–168.PubMedCrossRefGoogle Scholar
  23. Chassan, J.B. (1979). Research design in clinical psychology and psychiatry. New York: Halstead Press.Google Scholar
  24. Chouinard, G., & Jones, B.D. (1980). Neuroleptic-induced supersensitivity psychosis: Clinical and pharmacological characteristics. American Journal of Psychiatry, 137, 16–21PubMedGoogle Scholar
  25. Cohen, I.L., Campbell, M., Posner, D., Small, A.M., Trickel, D., & Anderson, L.T. (1980). Behavioral effects of haloperidol in young autistic children. Journal of the American Academy of Child Psychiatry, 19, 665–677.PubMedCrossRefGoogle Scholar
  26. Cole, J.O. (1982). Psychopharmacology update: Antipsychotic drugs: Is more better? McLean Hospital Journal, VII, 61–87.Google Scholar
  27. Cook, L., & Davidson, A.B. (1973). Effects of behaviorally active drugs in a conflict-punishment procedure in rats. In S. Garattini, E. Massini, & L.O. Randall (Eds.), The benzodiazepines. New York: Raven Press.Google Scholar
  28. Davis, K.V. (1971). The effect of drugs on stereotyped and nonstereotyped operant behaviors in retardates. Psychopharmacologia, 22, 195–213.PubMedCrossRefGoogle Scholar
  29. Davis, K.V., Sprague, R.L., & Werry, J.S. (1969). Stereotyped behavior and activity level in severe retardates: The effect of drugs. American Journal of Mental Deficiency, 73, 721–727.PubMedGoogle Scholar
  30. DiMascio, A., Soltys, J.J., & Shader, R.I. (1970). Psychotropic drug side effects in children. In R.I. Shader & A. DiMascio (Eds.), Psychotropic drug side effects (pp. 235–260 ). Baltimore: Williams & Wilkins.Google Scholar
  31. Durand, V.M. (1982). A behavioral/pharmacological intervention for the treatment of severe self-injurious behavior. Journal of Autism and Developmental Disorders, 12, 243–251.PubMedCrossRefGoogle Scholar
  32. Eaton, L.F., & Menolascino, F.H. (1982). Psychiatric disorders in the mentally retarded: Types, problems, and challenges. American Journal of Psychiatry, 139, 1297–1303.PubMedGoogle Scholar
  33. EDCEU. (1976). Assessment manual. Rockville, MD: National Institute of Mental Health.Google Scholar
  34. Ferguson, D.G., Cullari, S., & Gadow, K.D. (1987). Comment on the “Coldwater” studies. Journal of Mental Deficiency Research, 31, 219–220.Google Scholar
  35. Fielding, L.T., Murphy, R.J., Reagan, M.W., & Peterson, T.L. (1980). An assessment program to reduce drug use with the mentally retarded. Hospital and Community Psychiatry, 31, 771–773.PubMedGoogle Scholar
  36. Gadow, K.D. (1985). Prevalence and efficacy of stimulant drug use with mentally retarded children and youth. Psychopharmacology Bulletin, 21, 291–303.PubMedGoogle Scholar
  37. Gadow, K.D. (1987). Comments on the community drug treatment prevalence survey by Davis et al. (1981). Journal of Mental Deficiency Research, 31, 215–219.Google Scholar
  38. Goldstein, M., Anderson, L.T., Reuben, R., & Dancis, J. (1985). Self-mutilation in Lesch-Nyhan disease is caused by dopaminergic denervation. The Lancet, February 9, 338–339.Google Scholar
  39. Gualtieri, C.T. (1987). Letter to the editor. Journal of Mental Deficiency Research, 31, 222–223.Google Scholar
  40. Gualtieri, C.T., Hicks, R.E., Quade, D., & Schroeder, S.R. (1986). Tardive dyskinesia in young mentally retarded adults. Archives of General Psychiatry, 43, 335–340.PubMedGoogle Scholar
  41. Gualtieri, C.T., & Keppel, J.M. (1985). Psychopharmacology in the mentally re- tarded and a few related issues. Psychopharmacology Bulletin, 21, 304–309.PubMedGoogle Scholar
  42. Gualtieri, C.T., Quade, D., Hicks, R., Mayo, J.R., & Schroeder, S.R. (1984). Tardive dyskinesia and other clinical consequences of neuroleptic treatment in children and adolescents. American Journal of Psychiatry, 141, 20–23.PubMedGoogle Scholar
  43. Heistad, G T, Zimmerman, R.L., & Doebler, M.I. (1982). Long-term usefulness of thioridazine for institutionalized mentally retarded patients. American Journal of Mental Deficienty, 87, 243–254.Google Scholar
  44. Hill, B.K., Balow, E.A., & Bruininks, R.H. (1985). A national study of prescribed drugs in institutions and community residential facilities for mentally retarded people. Psychopharmacology Bulletin, 21, 279–284.PubMedGoogle Scholar
  45. Holden, C. (1986). NIMH review of fraud charge moves slowly. Science, 234, 1488–1489PubMedCrossRefGoogle Scholar
  46. Holden, C. (1987). NIMH finds a case of “serious misconduct.” Science, 235, 1566–1567.PubMedCrossRefGoogle Scholar
  47. Honigfeld, G. (1973). NOSIE-30: History and current status of its use in pharmacopsychiatric research. In P. Pichot & R. Olivier-Martin (Eds.), Modern problems in pharmacopsychiatry: Vol. 7 Psychological measurement (pp. 238–263 ). Basel: Karger.Google Scholar
  48. Hostetler, A.J. (1987, July) NIMH sends fraud case to Justice. The APA Monitor, 18, 18.Google Scholar
  49. Inoue, F. (1982). Neuroleptic withdrawal behavior-cases of cholinergic rebound supersensitivity. Clinical Pharmacy, 1, 567–569.PubMedGoogle Scholar
  50. Jakab, I. (1984). Short-term effect of thioridazine tablets versus suspension on emotionally disturbed/retarded children. Journal of Clinicial Psychopharmacology, 4, 210–215.Google Scholar
  51. James, D.H. (1983). Monitoring drugs in hospitals for the mentally handicapped. British Journal of Psychiatry, 142, 163–165.PubMedCrossRefGoogle Scholar
  52. Janke, W. (1980). Psychometric and psychophysiological actions of antipsychotics in men. In F. Hoffmeister & G. Stille (Eds.), Handbook of Experimental Pharmacology (Vol. 55, pp. 305–336 ). Berlin: Springer-Verlag.Google Scholar
  53. Johnston, J.M., Wallen, A., Partin, J., Neu, E., Cade, R.F., Stein, G.H., Goldstein, M.K., Pennypacker, H.S., & Gfeller, E. (1983). Human operant laboratory measurement of the effects of chemical variables. The Psychological Record, 33, 457–472.Google Scholar
  54. Jonas, O. (1980). Pattern of drug prescribing in a residential center for the intellectually handicapped. Australian Journal of Developmental Disabilities, 6–7, 25–29.Google Scholar
  55. Jones, R.R., Reid, J.B., & Patterson, G.R. (1975). Naturalistic observation in clinical assessment. In P. McReynolds (Ed.), Advances in psychological assessment (Vol. 3, pp. 42–95 ). San Francisco: Jossey-Bass.Google Scholar
  56. Kalachnik, J.E., Harder, S.R., & Kidd-Nielsen, P. (1984). Persistent tardive dyskinesia in randomly assigned neuroleptic reduction, neuroleptic nonreduction, and no-neuroleptic history groups: Preliminary results. Psychopharmacology Bulletin, 20, 27–32.PubMedGoogle Scholar
  57. Kalachnik, J.E., Lamm, J.G., & Swanson, A. (1983). A tardive dyskinesia moni- toring policy for applied facilities. Psychopharmacology Bulletin, 19, 277–282.PubMedGoogle Scholar
  58. Kalachnik, J.E., Miller, R.F., Jamison, A.G., & Harder, S. (1983). Results of a system to monitor effects of psychotropic medication in an applied setting. Psychopharmacology Bulletin, 19, 12–15.PubMedGoogle Scholar
  59. LaMendola, W., Zaharia, E.S., & Carver, M. (1980). Reducing psychotropic drug use in an institution for the retarded. Hospital and Community Psychiatry, 31, 271–272.PubMedGoogle Scholar
  60. Levenson, J.L. (1985). Neuroleptic malignant syndrome. American Journal of Psychiatry, 142, 1137–1145.PubMedGoogle Scholar
  61. Lewis, M.H., Steer, R.A. Favell, J., McGimsey, J., Clontz, L., Trivette, C., Jodry, W., Schroeder, S.R., Kanoy, R.C., & Mailman, R.B. (1986). Thioridazine and metabolite blood levels and effects on human stereotyped behavior. Psychopharmacology Bulletin, 22, 1040–1044.Google Scholar
  62. Lipman, R.S. (1970). The use of psychopharmacological agents in residential facilities for the retarded. In F.J. Menolascino (Ed.), Psychiatric approaches to mental retardation (pp. 387–398 ). New York: Basic Books.Google Scholar
  63. Lovaas, O.I. (1977). Language development through behavior modification. New York: Wiley.Google Scholar
  64. Lynch, D.M., Eliatamby, C.L.S., & Anderson, A.A. (1985). Pipothiazine palmitate in the management of aggressive mentally handicapped patients. British Journal of Psychiatry, 146, 525–529.PubMedCrossRefGoogle Scholar
  65. Marholin, D., Touchette, P., & Stewart, R.M. (1979). Withdrawal of chronic chlorpromazine medication: An experimental analysis. Journal of Applied Behavior Analysis, 12, 159–171.PubMedCrossRefGoogle Scholar
  66. Menolascino, F.J., Reudrich, S.L., Golden, C.J., & Wilson, J.E. (1985). Diagnosis and pharmacotherapy of schizophrenia in the retarded. Psychopharmacology Bulletin, 21, 316–322.PubMedGoogle Scholar
  67. Mouchka, S. (1985). Issues in pharmacology with the mentally retarded. Psychopharmacology Bulletin, 21, 262–267.PubMedGoogle Scholar
  68. Mueller, P.S. (1985). Neuroleptic malignant syndrome. Psychosomatics, 26, 654–662.PubMedGoogle Scholar
  69. Platt, J.E., Campbell, M., Green, W.H., & Grega, D.M. (1984). Cognitive effects of lithium carbonate and haloperidol in treatment-resistant aggressive children. Archives of General Psychiatry, 41, 657–662.PubMedGoogle Scholar
  70. Poling, A., Picker, M., & Hall-Johnson, E. (1983). Human behavioral pharmacology. The Psychological Record, 33, 473–493.Google Scholar
  71. Reiss, S., Levitan, G.W., & Szyszko, J. (1982). Emotional disturbance and mental retardation: Diagnostic overshadowing. American Journal of Mental Deficiency, 86, 567–574.PubMedGoogle Scholar
  72. Schooler, N., & Kane, J. (1982) Research diagnoses for tardive dyskinesia. Archives of General Psychiatry, 39, 486–487.PubMedGoogle Scholar
  73. Schroeder, S.R. Bickel, W., & Richmond, G. (1986). Primary and secondary prevention of self-injurious behavior. In K. Gadow (Ed.), Advances in learning and behavioral disabilities (Vol. 5, pp. 65–87 ). Grec, wich, CT: JAI Press.Google Scholar
  74. Schroeder, S.R., & Gualtieri, C.T. (1985). Behavioral interactions induced by chronic neuroleptic therapy with persons with mental retardation. Psychopharmacology Bulletin, 21, 323–326.PubMedGoogle Scholar
  75. Schroeder, S.R., Lewis, M.H., & Lipton, M.A. (1983). Interactions of pharmacotherapy and behavior therapy among children with learning and behavioral disorders. In K. Gadow & I. Bialer (Eds.), Advances in learning and behavioral disabilities (Vol. 2, pp. 179–225 ). Greenwich, CT: JAI Press.Google Scholar
  76. Silva, D.A. (1979). The use of medication in a residential institution for mentally retarded persons. Mental Retardation, 17, 285–288.PubMedGoogle Scholar
  77. Singh, N.N., & Aman, M.G. (1981). Effects of thioridazine dosage on the behavior of severely retarded persons. American Journal of Mental Deficiency, 85, 580–587.PubMedGoogle Scholar
  78. Snyder, S.H., Benerjee, S.P., Yamamura, H., & Greenberg, D. (1974). Drugs, neurotransmitters and schizophrenia. Science, 184, 1243–1253.PubMedCrossRefGoogle Scholar
  79. Sovner, R., & Hurley, A.D. (1983). Do the mentally retarded suffer from affective illness? Archives of General Psychiatry, 40, 61–67.PubMedGoogle Scholar
  80. Sprague, R.L. (1978). The Resident Behavior Rating Scale. Unpublished instrument, available from the author, Institute for Child Behavior and Development, University of Illinois, Champaign.Google Scholar
  81. Sprague, R.L. (1987). Letter to the editor. Journal of Mental Deficiency Research, 31, 223–225.Google Scholar
  82. Sprague, R.L., Kalachnik, J.E., Breuning, S.E., Davis, V.K., Ullman, R.K., Cullari, S., Davidson, N.A., Ferguson, D.G., & Hoffner, B.A. (1984). The Dyskinesia Identification System-Coldwater (DISCO): A tardive dyskinesia rating scale for the developmentally disabled. Psychopharmacology Bulletin, 30, 328–338.Google Scholar
  83. Sprague, R.L., & Werry, J.S. (1971). Methodology of psychopharmacological studies with the retarded. In N.R. Ellis (Ed.), International review of research in mental retardation (Vol. 5, pp. 147–219 ). New York: Academic Press.Google Scholar
  84. Tu, J. (1979). A survey of psychotropic medication in mental retardation facilities. Journal of Clinical Psychiatry, 40, 125–128.PubMedGoogle Scholar
  85. Tu, J., & Smith, J.T. (1983). The eastern Ontario Survey: A study of drug-treated psychiatric problems in the mentally handicapped. Canadian Journal of Psychiatry, 28, 270–276.Google Scholar
  86. Varia, I.M., & Taska, R.J. (1985). The neuroleptic malignant syndrome. Resident and Staff Physician, 31, 83–85.Google Scholar
  87. Werry, J.S., & Aman, M.G. (1975). Methylphenidate and haloperidol in children. Effects on attention, memory, and activity. Archives of General Psychiatry, 32, 790–795.PubMedGoogle Scholar
  88. White, T.J., & Aman, M.G. (1985). Pimozide treatment in disruptive severely retarded patients. Australian and New Zealand Journal of Psychiatry, 19, 92–94.PubMedCrossRefGoogle Scholar
  89. Wysocki, T., Fuqua, W., Davis, V., & Breuning, S.E. (1981). Effects of thioridazine (Mellaril) on titrating delayed matching-to-sample performance of mentally retarded adults. American Journal of Mental Deficiency, 85, 539–547.PubMedGoogle Scholar

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  • Stephen R. Schroeder

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