Pharmacological treatment for challenging behavior in adults with intellectual disability: Systematic review and meta-analysis

Rodrigo Campos-Jara; Cristian Martínez-Salazar; Christian Campos-Jara; José María Fernández; Darío Martínez-García; Falonn Contreras-Osorio

doi:10.1016/j.rpsm.2023.01.003

Pharmacological treatment for challenging behavior in adults with intellectual disability: Systematic review and meta-analysis

Rev Psiquiatr Salud Ment. 2023 Jan 31:S1888-9891(23)00004-6. doi: 10.1016/j.rpsm.2023.01.003. Online ahead of print.

[Article in English, Spanish]

Authors

Rodrigo Campos-Jara¹, Cristian Martínez-Salazar², Christian Campos-Jara³, José María Fernández¹, Darío Martínez-García⁴, Falonn Contreras-Osorio⁵

Affiliations

¹ Psychiatry Department, Hospital Mauricio Heyermann, Angol 4650207, Chile.
² Department of Physical Education, Sports, and Recreation, Pedagogy in Physical Education, School of Education and Social Sciences and Humanities, Universidad de La Frontera, Temuco 4780000, Chile.
³ Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile.
⁴ Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain.
⁵ Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile. Electronic address: falonn.contreras@unab.cl.

PMID: 37839961
DOI: 10.1016/j.rpsm.2023.01.003

Abstract

Introduction: Few evidence on the use of antipsychotics in people with intellectual disabilities and challenging behaviors, generates the need to develop studies that contribute to collect, compare and synthesize the available information. The present systematic review and meta-analysis aims to determine the clinical efficacy of antipsychotic medication in reducing critical episodes in this population.

Methods: We searched Web of Science, Scopus, EBSCO, Embase, and PubMed for randomized controlled trials of antipsychotic medication versus placebo. Preliminarily yielded 1354 abstracts and citations; six studies with 274 subjects met the inclusion criteria of studies with experimental design, longitudinal type, with pre- and post-intervention measurements.

Results: There is evidence for the use of psychotropic drugs in the acute management of challenging behaviors in patients with intellectual disability (SMD=-0.85; 95% CI=-1.69 to -0.01; p=0.05).

Conclusions: Our results coincide with the recommendations on the efficacy of the use of antipsychotics. Although our study provides evidence, the limited number of studies included in this research does not allow us to obtain totally conclusive results, although it can be considered as a guide for future studies.

Keywords: Challenging behavior; Intellectual disability; Pharmacological treatment.

Publication types

Review