Antipsychotics for aggression, irritability, and self injurious behavior in intellectual disability

(In: intellectual disability)

Antipsychotic medicine may be useful for reducing challenging behaviors. However, we should view these findings cautiously as many of the studies had significant methodologic limitations. Overall, the consensus seems to be that antipsychotics are helpful in the short term. Among them, aripiprazole and risperidone have the majority of studies and show effect sizes in the moderate to large range. There is little evidence on the long-term use of these medications. Given the significant side effects (weight gain, sedation, cardiovascular risks, extrapyramidal side effects, and increased prolactin levels, which are of particular concern in children), we should be very cautious when choosing to use these medications beyond an acute crisis.