title: Pharmacotherapy for mental health problems in people with intellectual disability.
abstract: OBJECTIVE
  Psychotropic medications are commonly prescribed to people with intellectual disability. We reviewed current evidence-based pharmacotherapy options and recent updates to guide clinicians in their medication management plans.
  
  
  RESULTS
  Antipsychotics, particularly risperidone, appear to be effective in reducing problem behaviors in children with intellectual disability. Evidence in adults is inconclusive. Methylphenidate appears to be effective, and α-agonists appear promising in reducing attention-deficit hyperactivity disorder symptoms. Lithium might be effective in reducing aggression. Evidence is limited to support the use of antiepileptic drugs, anxiolytics, and naltrexone for management of problem behaviors. Antidepressants may be poorly tolerated and might not be effective in reducing repetitive/stereotypic behaviors.In recent trials, glutamatergic and GABAergic agents for fragile X syndrome, and acetylcholinesterase inhibitors for Down's syndrome, failed to show efficacy. Growth hormone treatment might improve cognition and behavior in Prader-Willi syndrome population. Results from oxytocin trials on social behaviors are inconclusive albeit promising. Melatonin appears to improve sleep. Most trials of dietary supplements did not show benefits.
  
  
  CONCLUSIONS
  Evidence-based pharmacotherapy options in people with intellectual disability are limited, and many agents can cause substantial adverse events. For this reason, clinicians should consider pharmacotherapy as only a part of comprehensive treatment, and regularly assess drug effects, adverse events, and the feasibility of decreasing dose or withdrawing medications.
authors.affiliation: aKennedy Krieger Institute bDepartment of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Na Young
authors.initials: NY
authors.lastname: Ji
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
mesh_terms: D000374:Aggression / Q000187:drug effects*; D000927:Anticonvulsants / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D008607:Intellectual Disability / Q000150:complications* / Q000523:psychology; D018020:Lithium Compounds / Q000627:therapeutic use; D001523:Mental Disorders / Q000188:drug therapy*; D008774:Methylphenidate / Q000627:therapeutic use; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D011218:Prader-Willi Syndrome / Q000188:drug therapy; D011619:Psychotropic Drugs / Q000627:therapeutic use; D018967:Risperidone / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D018020:Lithium Compounds; D009292:Narcotic Antagonists; D011619:Psychotropic Drugs; D019382:Human Growth Hormone; D008774:Methylphenidate; D009271:Naltrexone; D018967:Risperidone