|
Sign In to gain access to subscriptions and/or personal tools.
|
This version was published on November
1, 2006
Journal of Psychopharmacology, Vol. 20, No. 6,
863-867 (2006)
DOI: 10.1177/0269881106067765
Aripiprazole use in individuals with intellectual disability and psychotic or behavioural disorders: a case series
Manan Shastri
Staff Grade Psychiatrist, Ealing Community Team for People with Intellectual Disabilities, Hanwell, London, UK
Lakshmiramana Alla
Staff Grade Psychiatrist, Three Bridges Regional Secure Unit, Southall, London, UK
Manga Sabaratnam
Consultant Psychiatrist, Ealing Community Team for People with Intellectual Disabilities, Hanwell, London, UK
People with intellectual disabilities may be at greater risk of developing movement disorders as a consequence of their underlying neurological damage, especially when they are treated with typical antipsychotic agents. Aripiprazole is a novel antipsychotic quinolone derivative that has been approved for the treatment of schizophrenia in adults. However, there are few reports on the use of aripiprazole in people with intellectual disabilities. Herein, we report on the use of aripiprazole in five individuals with intellectual disabilities and psychotic illness (four cases) or challenging behaviour (one case). Four of the five patients had an additional diagnosis of schizophrenia and one had autism spectrum disorder and challenging behaviour. Issues related to the usefulness of aripiprazole in the management of schizophrenia and challenging behaviour in people with intellectual disabilities are also discussed. Aripiprazole was well tolerated and effective in each of the cases and appears to be a safe and efficacious alternative in the management of patients with both intellectual disabilities and schizophrenia. It can also be a useful treatment option in the management of challenging behaviour, especially when it is used as a part of a biopsychosocial approach.
Key Words: aripiprazole • schizophrenia • intellectual disability • psychotic disorders • behavioural disorders • challenging behaviour
References
- Clarke D J, Kelley S, Thinn K, Corbett J A (1990) Psychotropic drugs and mental retardation: 1. Disabilities and the prescription of drugs for behaviour and for epilepsy in three residential settings . J Ment Defic Res 34: 385–395 .
- Eaton L F, Menolascino F J (1982) Psychiatric disorders in the mentally retarded: types, problems and challenges . Am J Psychiatry 139: 1297–1303 .[Abstract/Free Full Text]
- Emerson E, Toogood A, Mansell J (1987) Challenging behaviour and community services: I. introduction and overview . Mental handicap 15: 166–169 .
- Gallucci G, Mernaugh L, Dyson D (2004) Aripiprazole use in an individual with intellectual disability and schizoaffective disorder . Ment Health Aspect Development Disabil 7: 53–56 .
- Gillberg C, Persson E, Grufman M, Themmer U (1986) Psychiatric disorders in mildly and severely mentally retarded urban children and adolescents: epidemiological aspects . Br J Psychiatry 149: 68–74 .[Abstract/Free Full Text]
- Gingell K, Nadarajah J (1994) A controlled community study of movement disorder in people with learning difficulties on antipsychotic medication . J Intellect Disabil Res 37: 53–59 .[Medline]
[Order article via Infotrieve]
- Halbreich V, Kahn L S (2003) Hormonal aspects of schizophrenia: an overview . Psychoneuroendocrinology 28(suppl. 2): 1–16 .[ISI][Medline]
[Order article via Infotrieve]
- Haw C, Stubbs J (2005) A survey of off-label prescribing for patients with mild intellectual disability and mental illness . J Intellect Disabil Res 49: 858–864 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Heaton-Ward A (1977) Psychosis in mental handicap. The tenth Blake Marsh lecture delivered before the Royal College of Psychiatrists, February 2, 1976 . Br J Psychiatry 130: 525–533 .[Free Full Text]
- Kikuchi T, Tottori K, Uwahodo Y (1995) ( OPC-14597), a new putative antipsychotic drug with both presynaptic dopamine autoreceptor agonistic activity and postsynaptic D2 receptor antagonistic activity . J Pharmacol Exp Ther 274: 329-336 .[Abstract/Free Full Text]
- Lean M E, Pajonk F G (2003) Patients on atypical antipsychotic drugs: Another high-risk group for type 2 diabetes . Diabetes Care 26: 1597–1605 .[Abstract/Free Full Text]
- Lund J (1985) The prevalence of psychiatric morbidity in mentally retarded adults . Acta Psychiatr Scand 72: 563–570 .[ISI][Medline]
[Order article via Infotrieve]
- McDougle C J, Kem D L, Posey D J (2002) Use of ziprasidone for maladaptive symptoms in youths with autism . J Am Acad Child Adolesc Psychiatry 41: 921–927 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Marder S R, Mcquade R D, Stock E (2003) Aripiprazole in the treatment of schizophrenia: safety and tolerability in short-term, placebo-controlled trials . Schizophr Res 61: 123–136 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Millan M J (2000) Improving the treatment of schizophrenia: focus on serotonin (5HT1a receptors) . J Pharmacol Exp Ther 295: 853–861 .[Abstract/Free Full Text]
- Richelson E (1999) Receptor pharmacology of neuroleptics: relation to clinical effects . J Clin Psychiatry 60: 5–14 .[ISI][Medline]
[Order article via Infotrieve]
- Rogers D, Karki C, Bartlett C, Pocock P (1991) The motor disorders of mental handicap. An overlap with the motor disorders of severe psychiatric illness . Br J Psychiatry 158: 97–102 .[Abstract/Free Full Text]
- Sachdev P (1992) Drug-induced movement disorders in institutionalised adults with mental retardation. Clinical characteristics and risk factors . Aust N Z J Psychiatry 26: 242–248 .[ISI][Medline]
[Order article via Infotrieve]
- Stahl S (2002) Essential Psychopharmacology of Antipsychotics and Mood Stabilizers. Cambridge University Press, Cambridge .
- Staller J A (2003) Aripiprazole in an adult with Asperger Disorder . Ann pharmacother 37: 1628–1631 .[Abstract/Free Full Text]
- Stigler K A, Posey D J, Mcdougle D J (2004) Aripiprazole for maladaptive behaviour in pervasive developmental disorders . J Child Adol Psychopharm 14: 455-463 .
- Sussman N (2003) The implications of weight changes with antipsychotic treatment . J Clin Psychopharmacol 23(3 suppl. 1): S21–S26 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Youssef H A, Waddington J L (1988) Involuntary orofacial movements in hospitalised patients with mental handicap or epilepsy: relationship to developmental/intellectual deficit and presence or absence of long-term exposure to neuroleptics . J Neurol Neurosurg Psychiatry 51: 863–865 [Abstract]
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
J. M Stachnik and C. Nunn-Thompson
Use of Atypical Antipsychotics in the Treatment of Autistic Disorder
Ann. Pharmacother.,
April 1, 2007;
41(4):
626 - 634.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
