Use of Medications in the Treatment of Aggressive Behavior

Abstract

Aggressive behavior can be dangerous, and it is often associated with reduced quality of life for people with IDD. Many factors have been identified that contribute to its occurrence, and often an environmental influence can be identified. The use of psychotropic medications to treat aggressive behaviors of individuals with IDD has been controversial. Some limited support exists that risperidone and aripiprazole can be helpful in short-term treatment of challenging behaviors in children with autism spectrum disorder (ASD). However, use of medications to treat aggressive behavior in people with IDD is only recommended when multidisciplinary assessment and treatment options with less risk are exhausted and when the clinical challenges involve significant disruption to safety or quality of life. Despite this being the prevailing opinion outlined in numerous best practice guidelines, psychotropic medication use is high in the population. Polypharmacy is very common, and a large percentage of individuals with IDD are treated with antipsychotic medications. A few studies have looked at clinicians’ rationales for prescriptive practices. In several studies now, it has been demonstrated that a large percentage of people with IDD can be successfully tapered off of antipsychotics. Despite the wide use of psychotropics in the population, only a small number of studies report the nature and extent of side effects, pointing to one area of need in future research. No studies compared use of medications with use of behavioral or other nonmedical interventions, and it was found that many of the people treated with psychotropics did not have other modalities of treatment in place.