Paliperidone Use in Behavioural Symptoms in Patients with Intellectual Disabilities

Abstract

Introduction Behavioural symptoms are the first reason of psychiatric assessment in patients with intellectual disabilities (ID), and also the most frequent cause of psychopharmacological treatment. Different rates of prevalence of these symptoms appear in literature data (10-60%). Paliperidone has shown effectiveness in the treatment of behavioural symptoms in patients with autism and asperger syndrome, with significant reduction in ABC-I subscale scores. Conclusions Objectives: Study paliperidone effect in behavioural symptoms' improvement in patients with intellectual disabilities of diverse etiology. Methods 10 outpatients with intellectual disabilities and behavioral symptoms were selected and treated with paliperidone. Sociodemographic and clinical data (type of intellectual disability, previous antipsychotic and paliperidone dose) were registered. Agitation subscale Aberrant Behavior Checklist (ABC-I) scores were compared prior and 4 weeks after psychopharmacological treatment change. Otherwise we assessed clinical improvement with Clinical Global Impression-Improvement (CGI-I). Results All patients were similar in clinical and sociodemographic characteristics. Paliperidone mean dose was 8,4 mg/day (3-18 mg/day), changing from risperidone (44,4%), olanzapine (44,4%) and levomepromacine (11,1%). Mean reduction in ABC-I scores with paliperidone treatment was 6,2 points [with most significant improvement in items like irritability (1,2 points), aggressions (1,1 points) and slams (0,9 points)]. CGI-I scores showed a much better improvement in 60% patients, mildly betterin 30% patients and slightly better in 10% patients. No significant adverse effects leaded to treatment discontinuation. Conclusions 1. Paliperidone is an effective and safe treatment in behavioral symptoms associated to intellectual disabilities. 2. Paliperidone treatment reduces ABC-I subscale scores, with most significant improvement in irritability and aggressions.