Pills may no longer prove beneficial for the treatment of aggression in people with intellectual disabilities, for a new study has revealed that antipsychotic drugs may not be the best cure for aggressive tendencies like road rage, domestic violence, head banging etc.
Antipsychotic drugs, normally used for schizophrenics, have been prescribed for treating aggression in intellectually disabled patients since long. However, the researchers could not find any evidence to prove its effectiveness and suggested a more expensive treatment like psychological intervention.
"Antipsychotic drugs are widely used because they are cheap and at high doses they sedate people," the Lancet quoted Eric Emerson at Lancaster University, an expert in the behaviour of intellectually disabled people, as saying.
This international research project, led by Peter Tyrer, based at Imperial College London, examined 86 intellectually disabled people at various clinics in England, Wales and at one centre in Australia.
It was found that patients who were being treated for aggression were given either two of the antipsychotic drugs, respiridone or haloperidol, or they were given a placebo.
These drugs, work by blocking dopamine D2 receptors in the brain and thus result in less dopamine in the limbic pathway of these patients, and do not reach the part of the brain associated with addiction, reward and fear. Dopamine is a key neurotransmitter of arousal.
"The drugs dampen down all behaviours, not just aggression," said John Taylor, president elect of the British Association for Behavioural and Cognitive Psychotherapies.
Respiridone and haloperidol are dirty drugs, with lots of side effects like drooling, shaking, seizures, dry mouth, weight gain, skin rashes and so on," said Tyrer.
A careworker, who did not know which medication the patients had taken, assessed the behaviour of patients taking these drugs against a standard measure of aggression at 4 weeks, 12 weeks, and 26 weeks.
Though, a substantial decrease was noticed at 4 weeks with all three treatments, placebo topped with a 79 percent success rate as compared to 58 percent for respiridone and 65 percent for haloperidol. However, all the three treatments had similar effects at subsequent stages.
These results question the use of antipsychotic drugs in the treatment of aggressive behaviour, according to the researchers.
Psychological intervention, which is a more expensive treatment, instead of medication, is given to people of average intelligence who get aggressive. These include people who suffer extreme road rage or are violent towards their loved ones.
Now Tyrer is chairing a group for the UK's National Institute of Clinical Excellence, for making guidelines for treating aggressive behaviour in people with intellectual disability.