Brief report: effects of clozapine on self-injurious behavior of two risperidone nonresponders with mental retardation.

Doctors gave two adults with profound intellectual disability a daily pill called clozapine. Both adults had severe self-biting and aggression that did not improve with risperidone or other drugs. The team watched the adults for several weeks to see if the new pill helped.

This was a small case series. No control group, no fancy design—just close daily notes on two people who had run out of options.

Both adults calmed down fast. Self-biting and hits dropped to near zero on 200 mg of clozapine each day. The change was large and stayed put while the pill was given.

Staff reported the adults looked more relaxed and could take part in small activities again.

Taylor et al. (1993) also tried a drug in kids with ID, but they used monthly FGF shots to raise IQ scores. Both studies show pills can help people with ID, yet they target different problems—behavior versus thinking.

Wing (1981) got rid of fear in kids with ID by using mom-led modeling, no drugs at all. The clozapine paper adds a medical route when behavior methods and risperidone fail.

Chung et al. (2010) found mixed results with quick warm-up games before sessions. Their work reminds us that not every trick works for every client—drug or no drug.

If you have a client with profound ID whose self-injury keeps going after risperidone, clozapine may be a next step. Share this brief report with the prescribing doctor and ask for close blood monitoring. Track aggression and self-bite counts daily so you can show if the new pill is worth the risk.