Olanzapine for Self-Injurious, Aggressive, and Disruptive Behaviors in Intellectually Disabled Adults: A Retrospective, Open-Label, Naturalistic Trial
J Clin Psychiatry 2003;64:1258-1265
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The effectiveness of olanzapine in
treating challenging behaviors in the intellectually disabled and
its ability to substitute for conventional antipsychotic drugs
Method: A total of 20 institutionalized adults
with a mean age of 42.7 years (range, 18-55 years) with
intellectual disability and aggression, self-injurious behavior,
destructive/disruptive behavior, or combinations of these
behaviors were studied. These individuals were receiving multiple
psychotropic medications at baseline and were given additional
treatment with the atypical antipsychotic agent olanzapine. The
mean dose of olanzapine was 9.1 mg/day (range, 2.5-22.5 mg/day).
Effectiveness was determined by retrospective review of the
summaries of quarterly neuropsychiatric behavioral reviews and
retrospective review of longitudinal behavioral graphs of target
symptoms. Data were collected from 1995 to 2000.
Results: A significant decrease in global
challenging behaviors and specific target behaviors (i.e.,
aggression, self-injurious behaviors, destructive/
disruptive behaviors) occurred (p < .05). A
numericaldecrease in the dosage of concurrent conventional
antipsychotic medications occurred over the course of the first 6
months of olanzapine therapy, and a statistically significant (p
< .005) decrease from the start of olanzapine therapy occurred
in those subjects who received olanzapine for longer than 6
months (mean = 20.3 months). A significant increase in weight
occurred in the subject group during the first 6 months of
olanzapine treatment (p < .006), and sedation and constipation
were the other common side effects noted.
Conclusions: Olanzapine was found to be
effective in the treatment of challenging behaviors in the
intellectually disabled and in part could be substituted for
administration of conventional antipsychotic drugs.