Pharmacological interventions for self-injurious behaviour in adults with intellectual disabilities: Abridged republication of a Cochrane systematic review.
We aimed to determine clinical effectiveness of pharmacological interventions for self-injurious behaviour in adults with intellectual disability. We searched the following databases: CENTRAL; MEDLINE; EMBASE; PsycINFO; CINAHL; SCI; SSCI; Conference Proceedings Citation Index - Science; Conference Proceedings Citation Index - Social Science and Humanities; ZETOC; World Cat .We also searched ClinicalTrials.gov,ICTRP and the reference lists of included trials. We included randomised controlled trials that examined drug interventions versus placebo for self-injurious behaviour. We found five double-blind, placebo-controlled trials, which included a total of 50 people. Four trials compared the effects of naltrexone versus placebo and one trial clomipramine versus placebo. We did not identify any relevant placebo-controlled trials for other drugs. We presented a narrative summary, as meta-analysis was not appropriate due to differences in study designs, differences between interventions and heterogeneous outcome measures. There was weak evidence in included trials that any active drug was more effective than placebo for people with intellectual disability demonstrating self-injurious behaviour. Due to sparse data, an absence of power and statistical significance, and high risk of bias for four of the included trials, we are unable to reach any definite conclusions about the relative benefits of naltrexone or clomipramine compared to placebo.
Southern Health NHS Foundation Trust, Psychiatry of Intellectual Disability, Oxford, UK aynurdemirel@yahoo.com.
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Gormez
Southern Health NHS Foundation Trust, Psychiatry of Intellectual Disability, Oxford, UK.
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Rana
Black Country Partnership NHS Foundation Trust, Psychiatry of Intellectual Disability, Wolverhampton, UK.
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Varghese
D002997:Clomipramine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D009271:Naltrexone / Q000009:adverse effects / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D019989:Persons with Intellectual Disabilities / Q000523:psychology*; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D002997:Clomipramine; D009271:Naltrexone; D009292:Narcotic Antagonists; D017367:Selective Serotonin Reuptake Inhibitors
Self-injurious behaviour; intellectual disability; pharmacological interventions