Pharmacological interventions for challenging behaviour in children with intellectual disabilities: A systematic review and meta-analysis

Cheryl McQuire, Angela Hassiotis*, Bronwyn Harrison, Stephen Pilling

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

35 Citations (Scopus)

Abstract

Background: Psychotropic medications are frequently used to treat challenging behaviour in children with intellectual disabilities, despite a lack of evidence for their efficacy. This systematic review and meta-analysis aimed to determine the safety and efficacy of pharmacological interventions for challenging behaviour among children with intellectual disabilities. Methods: Electronic databases were searched and supplemented with a hand search of reference lists and trial registries. Randomised controlled trials of pharmacological interventions for challenging behaviour among children with intellectual disabilities were included. Data were analysed using meta-analysis or described narratively if meta-analysis was not possible. For quality assessment, the Cochrane Risk of Bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were used. Results: Fourteen studies including 912 participants met inclusion criteria. Antipsychotic medication reduced challenging behaviour among children with intellectual disabilities in the short-term (SMD = -1.09, p < 0.001 for risperidone; SMD = -0.64, p < 0.001 for aripiprazole). However, there were significant side-effects including elevated prolactin levels (SMD = 3.22, p < 0.001) and weight gain (SMD = 0.82, p < 0.001). Evidence was inconclusive regarding the effectiveness of anticonvulsants and antioxidants for reducing challenging behaviour. The quality of all evidence was low and there were no long term follow up studies. Conclusions: Antipsychotic medications appear to be effective for reducing challenging behaviour in the short-term among children with intellectual disabilities, but they carry a risk of significant side effects. Findings from this review must be interpreted with caution as studies were typically of low quality and most outcomes were based on a small number of studies. Further long-term, high-quality research is needed to determine the effectiveness and safety of psychotropic medication for reducing challenging behaviour.

Original languageEnglish
Article number303
JournalBMC Psychiatry
Volume15
DOIs
Publication statusPublished - 26 Nov 2015

Keywords

  • Antipsychotics
  • Challenging behaviour
  • Intellectual disabilities
  • Meta-analysis
  • Pharmacological treatment
  • Randomised controlled trials
  • Systematic review

Fingerprint

Dive into the research topics of 'Pharmacological interventions for challenging behaviour in children with intellectual disabilities: A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this