Paroxetine in depressed adolescents with intellectual disability: an open label study.

Doctors gave paroxetine to seven teens who had both mild intellectual disability and major depression. They raised the dose slowly until each teen reached 20-40 mg per day. After nine weeks they checked if the teens still met the rules for major depression.

This was an open-label study. Everyone knew they were getting the real drug. There was no placebo group.

Four of the seven teens no longer counted as depressed. Their depression scores dropped by almost half. Side effects were mild and did not last long.

The three teens who did not reach remission still had some improvement, just not enough to cross the line.

Farrant et al. (1998) used the same small case-series style to test risperidone for aggression in adults with ID. Both papers show promise, but both lack control groups. The weak design means positive results could be coincidence or placebo.

Titlestad et al. (2019) later ran a real RCT on risperidone in adults with ID. They found stopping the drug did not worsen irritability. That stronger study tempers the early cheer from Farrant et al. (1998) and warns us not to trust small open trials too much.

Matson et al. (2008) tracked fifty adults on atypical antipsychotics for one year. Aggression dropped, yet self-injury stayed flat and weight rose. Their larger sample and longer view extend the target paper’s idea that medication can help, but benefits may be narrow and come with costs.

You may see teens with ID and depression who are already on paroxetine or whose parents ask about it. This study gives you a number to share: about half reached remission in nine weeks. Remind the team that the evidence is tiny and uncontrolled. Track mood with simple rating scales and watch for activation or nausea. Pair any med trial with solid behavior plans and sleep routines so you are not relying on a pill alone.