Abstract
Psychoactive drugs are often prescribed to control challenging behaviors of individuals with mental retardation. We examined the effects of drug changes and physician’s prescribing behavior on the aggressive and collateral behaviors of three individuals with severe and profound mental retardation. Despite repeated drug changes over the course of 2 years, no decrease in aggression was observed for any of the three subjects. In fact, with one of the clients (X.W.) aggression was more problematic after two years of attempted pharmaceutical control. Observed confounds to assessing behavior control included: the lack of withdrawal phases; unsystematic dosage manipulations; potential history and maturational effects; polypharmacy; and unreliable qualitative measures. Future psychopharmacological research should include the prescribing behavior of physicians as an ecobehavioral variable that may impact treatment outcome.
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References
Aman, M. G., and Singh, N. N. (1991). Pharmacological intervention. In Matson, J., and Mulick, J. (eds.),Handbook of Mental Retardation. Pergamon Press, New York, pp. 347–372.
Aman, M. J., Singh, N. N., and Fitzpatrick, J. (1987a). The relationship between nurse characteristics and perceptions of psychotropic medications in residential facilities for the retarded.J. Aut. Devel. Dis. 17: 511–523.
Aman, M. G., Singh, N. N., and White, A. J. (1987b). Caregiver perceptions of psychotropic medication in residential facilities.Res. Devel. Dis. 8: 449–465.
Baumeister, A. A., and Sevin, J. A. (1990). Pharmacologic control of aberrant behavior in the mentally retarded: Toward a more rational approach.Neurosci. Biobehav. Rev. 14: 253–262.
Bevan, P., Cools, A., and Archer, T. (1989).Behavioral Pharmacology of 5-HT, Lawrence Erlbaum Associates, New Jersey.
Findholt, N. E., and Emmett, C. G. (1990). Impact of interdisciplinary team review on psychotropic drug use with persons who have mental retardation.Ment. Retard. 28: 41–46.
Gadow, K. D., and Poling, A. D. (1988).Pharmacotherapy and Mental Retardation, College-Hill Press, Boston.
Glaser, B. A., and Morreau, L. E. (1986). Effects of interdisciplinary team review on the use of antipsychotic agents with severely and profoundly mentally retarded persons.Am. J. Ment. Def. 90: 371–379.
Harper, D. C., and Wadsworth, J. S. (1993). Behavioral problems and medication utilization.Ment. Retard 31: 97–103.
Linaker, O. M. (1990). Frequency of and determinants for psychotropic drug use in an institution for the mentally retarded.Brit. J. Psychiatry 156: 525–530.
Markovitz, P. J., Stagno, S. J., and Calabrese, J. R. (1990). Buspirone augmentation of fluoxetine in obsessive-compulsive disorder.Am. J. Psychiatry 147: 798–800.
Neppe, V. (1991, Feb.).Implications of the Serotonin 1-A Receptor, Paper presented at the meeting of the Nevada Association of Psychiatric Physicians, Reno, NV.
Physicians’ Desk Reference (1991). Medical Economics Data, New Jersey.
Ratey, J., Sovner, R., Parks, A., and Rogentine, K. (1991). Buspirone treatment of aggression and anxiety in mentally retarded patients: A multiple-baseline, placebo lead-in study.J. Clin. Psychiatry 52: 159–162.
Ratey, J. J., Sovner, R., Mikkelsen, E., and Chmeilinski, H. E. (1989). Buspirone therapy for maladaptive behavior and anxiety in developmentally disabled persons.J. Clin. Psychiatry 50: 382–384.
Ricketts, R. W., Goza, A. B., Ellis, C. R., Singh, Y. N., Singh, N. N., and Cooke III, J. C. (1993). Fluoxetine treatment of severe self-injury in young adults with mental retardation.J. Am. Acad. Child Adol. Psychiatry 32: 865–869.
Ricketts, R. W., Goza, A. B., Ellis, C. R., Singh, Y. N., Chambers, S., Singh, N. N., and Cooke III, J. C. (1994). Clinical effects of buspirone on intractable self-injury in adults with mental retardation.J. Am. Acad. Child and Adol. Psychiatry 33: 270–276.
Singh, N. N., and Repp, A. C. (1988). The behavioral and pharmacological management of problem behaviors in people with mental retardation.Irish J. Psychol. 9: 264–285.
Singh, N. N., and Winton, A. S. W. (1984). Behavioral monitoring of pharmacological interventions for self-injury,Appl. Res. Ment. Retard. 5: 161–170.
Stroffe, D., and Hayes, L. J. (1991).A preliminary study of the efficacy of PRN medication usage in the developmentally disabled, Poster presented at the meeting of the California Association for Behavior Analysis, San Francisco, CA.
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Fredericks, D.W., Hayes, L.J. Effects of drug changes and physician prescribing practices on the behavior of persons with mental retardation. J Dev Phys Disabil 7, 105–122 (1995). https://doi.org/10.1007/BF02684956
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DOI: https://doi.org/10.1007/BF02684956