The use of risperidone among individuals with mental retardation: clinically supported or not?
Risperidone for challenging behavior in people with intellectual disability still lacks strong proof—prescribe only with caution and close monitoring.
01Research in Context
What this study did
The authors looked at every paper on risperidone for people with intellectual disability. They wanted clear proof the drug cuts challenging behavior.
They only found weak or tiny studies. No big, clean trial showed the drug works.
What they found
The team said the evidence is 'questionable.' They could not give a thumbs-up for using the drug.
In plain words: we still do not know if risperidone really helps this group.
How this fits with other research
Eisenhower et al. (2006) ran a crossover study the next year. They saw big drops in irritability for most adults and kids with mental retardation. This sounds like a contradiction, but the 2006 study was small and had no placebo arm for half the data.
La Malfa et al. (2004) also tested risperidone in adults with ID. They found the DASH-II scale missed change, while the ABC-C caught it. This helps explain why early reviews called the evidence weak: we were using blunt rulers.
Hattier et al. (2011) later mapped every antipsychotic RCT in ID. They found the same mess: tiny samples, 25-plus outcome measures, and no clear ID labels. Their paper supports the 2005 warning that the field needs bigger, cleaner trials.
Why it matters
If a family asks about risperidone, show them this review. Say the drug might help, but solid proof is missing. Track behavior with the ABC-C, not the DASH-II. Keep an eye on weight and appetite. Push for a baseline and follow-up plan, and always pair medicine with behavior supports.
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02At a glance
03Original abstract
Since their introduction, antipsychotic medications have been used widely to treat conditions other than psychiatric disorders, especially among individuals with mental retardation. Researchers have shown that the prevalence rates of psychotropic medication prescriptions among this population are extremely high. Given the limited empirical data to support the use of psychotropic medications, specifically antipsychotics, among individuals with mental retardation, this trend is a cause for concern. This review was undertaken in an effort to summarize the available studies regarding the use of the atypical antipsychotic drug risperidone among individuals with mental retardation and provide a resource for clinicians, care givers, and parents. Based on the results of this review, the effectiveness of risperidone in targeting psychopathology and challenging behaviors for individuals with mental retardation is questionable at present.
Research in developmental disabilities, 2005 · doi:10.1016/j.ridd.2004.07.001