Risperidone for attention-deficit hyperactivity disorder in people with intellectual disabilities.
BACKGROUND
Attention deficit hyperactivity disorder (ADHD) is increasingly recognised as occurring in people with intellectual disability (ID), although treatment of ADHD in this population has not ben tested widely. Risperidone has been used to treat ADHD in people with ID, although the evidence for its effectiveness is unclear.


OBJECTIVE
To examine the effectiveness of risperidone for the treatment of attention deficit hyperactivity disorder in people with intellectual disabilities.


METHODS
In February 2009, MEDLINE, PsycINFO, EMBASE, AMED, ISI Web of Science and WorldCat Dissertations were searched using an extensive list of synonyms for ADHD and ID. CENTRAL, CCDPLP, Current Controlled Trials meta-register (mRCT), CenterWatch, NHS National Research Register, clinicaltrials.gov were searched, pharmaceutical companies and experts in the field were contacted. Reference lists of review articles were examined and citation searches were performed in ISI Web of Knowledge.


METHODS
All randomised controlled trials (RCTs), both published and unpublished, in any language, in which children or adults with ADHD and ID were treated with risperidone.


METHODS
Data collection and analyses were planned but not performed due to a lack of suitable studies.


RESULTS
Eleven studies were considered but none were suitable for inclusion.


CONCLUSIONS
There is no evidence from RCTs that risperidone is effective for the treatment of ADHD in people with ID. Prescribing in this population can only be based on open-label studies or extrapolation from research in people with autism and disruptive behaviour disorders; however these studies have not investigated people with ID separately so there are reservations regarding the applicability of these findings. Research into effectiveness and tolerability is urgently needed.
Section of Brain Maturation (P050), Kings College London, Institute of Psychiatry, De Crespigny Park, London, UK, SE5 8AF. alex.thomson@iop.kcl.ac.uk
Alex
A
Thomson
Stefanos
S
Maltezos
Elena
E
Paliokosta
Kiriakos
K
Xenitidis
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology; D002648:Child; D006801:Humans; D019989:Persons with Intellectual Disabilities / Q000523:psychology*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D018967:Risperidone / Q000627:therapeutic use*
D011619:Psychotropic Drugs; D018967:Risperidone