Therapeutic effects and long-term efficacy of antidepressant medication for persons with developmental disabilities. Behavioral assessment in two cases of treatment-resistant aggression and self-injury.

Two adults with autism and intellectual disability had hurt themselves or others for years. No behavioral plan had worked.

Doctors gave one person sertraline and the other clomipramine. The team kept daily behavior logs for months.

Sertraline cut self-injury to near zero. Clomipramine stopped aggression completely. The gains stayed for the whole follow-up.

Both people needed no extra physical holds or PRN meds after the drugs kicked in.

Iwata et al. (1990) warned that shiny sensory therapies can look helpful until you run a real functional analysis. Their fake gains vanished once reinforcement was spotted. K et al. used the same careful tracking and still saw big, lasting drops, so the drug effect seems real, not artifact.

Martin et al. (1997) showed you can curb self-injury with non-contingent toys and snacks. K et al. prove pills can also work when behavioral tricks fail. The two studies sit side-by-side: try ABA first, keep meds in your back pocket.

Corrigan et al. (1998) paired sensory toys with response blocking to wipe out destruction. K et al. add antidepressants to the short list of options when behavior plans hit a wall.

You now have a tiny but clear signal that sertraline or clomipramine can rescue the toughest SIB or aggression cases. Document baseline rates, start one drug, graph daily, and give it weeks before you quit. Combine the pill with your behavioral plan; don’t swap them. Share the data with the prescribing doctor so dose tweaks are data-driven, not guesswork.