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The effectiveness of aripiprazole in the management of problem behaviour in people with intellectual disabilities, developmental disabilities and/or autistic spectrum disorder--a systematic review.
Res Dev Disabil. 2014 Mar; 35(3):711-25.RD

Abstract

The management of problem behaviours (PB) in individuals with intellectual disabilities (ID), developmental disabilities (DD) and/or autistic spectrum disorders (ASD) can be challenging. Antipsychotic medications are commonly prescribed where other strategies have failed. A systematic review (SR) was conducted to establish the research evidence for the efficacy of aripiprazole in the management of PB in adults and children with ID, DD and/or ASD. Although included studies supported the efficacy of aripiprazole for this indication, the overall quality of studies was poor. Of the 20 studies included in this systematic review there were only two randomised controlled trials (RCTs) on children with ASD and/or ID/DD, both of which were conducted by the pharmaceutical company that manufactures aripiprazole, and it is not clear whether a number of same participants were included in both RCTs. One of the RCTs was extended into an open label long term follow up, which showed that aripiprazole's efficacy lasted over 52 weeks and the adverse effects were tolerable. Four studies were open label prospective studies, 11 were retrospective case reports which included four single case reports, and two were prospective case series. Most studies reported adverse effects from aripiprazole in the form of weight gain, increased appetite, sedation, tiredness, drooling and tremor. However, aripiprazole improved serum prolactin level in some participants and overall did not show any adverse effect on QTc interval. There is a need for more carefully designed RCTs into the use of aripiprazole in the management of PB in people with ID/DD and/or ASD, which should be carried out independent of pharmaceutical companies.

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Authors+Show Affiliations

Deb S
Imperial College, London, UK.
Farmah BK
School of Psychiatry, West Midlands Deanery, Birmingham, UK.
Arshad E
University of Birmingham, UK.
Deb T
Imperial College, London, UK.
Roy M
Birmingham Community Healthcare NHS Trust, UK. Electronic address: meera.roy@nhs.net.
Unwin GL
School of Psychology, University of Birmingham, UK.

MeSH

AggressionAntipsychotic AgentsAripiprazoleChild Development Disorders, PervasiveDevelopmental DisabilitiesHumansIntellectual DisabilityMental DisordersPiperazinesQuinolonesSelf-Injurious BehaviorTreatment Outcome

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

24405794

Citation

Deb, Shoumitro, et al. "The Effectiveness of Aripiprazole in the Management of Problem Behaviour in People With Intellectual Disabilities, Developmental Disabilities And/or Autistic Spectrum Disorder--a Systematic Review." Research in Developmental Disabilities, vol. 35, no. 3, 2014, pp. 711-25.
Deb S, Farmah BK, Arshad E, et al. The effectiveness of aripiprazole in the management of problem behaviour in people with intellectual disabilities, developmental disabilities and/or autistic spectrum disorder--a systematic review. Res Dev Disabil. 2014;35(3):711-25.
Deb, S., Farmah, B. K., Arshad, E., Deb, T., Roy, M., & Unwin, G. L. (2014). The effectiveness of aripiprazole in the management of problem behaviour in people with intellectual disabilities, developmental disabilities and/or autistic spectrum disorder--a systematic review. Research in Developmental Disabilities, 35(3), 711-25. https://doi.org/10.1016/j.ridd.2013.12.004
Deb S, et al. The Effectiveness of Aripiprazole in the Management of Problem Behaviour in People With Intellectual Disabilities, Developmental Disabilities And/or Autistic Spectrum Disorder--a Systematic Review. Res Dev Disabil. 2014;35(3):711-25. PubMed PMID: 24405794.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effectiveness of aripiprazole in the management of problem behaviour in people with intellectual disabilities, developmental disabilities and/or autistic spectrum disorder--a systematic review. AU - Deb,Shoumitro, AU - Farmah,Baldeep K, AU - Arshad,Ebrahim, AU - Deb,Tanya, AU - Roy,Meera, AU - Unwin,Gemma L, Y1 - 2014/01/07/ PY - 2013/10/23/received PY - 2013/12/10/accepted PY - 2014/1/11/entrez PY - 2014/1/11/pubmed PY - 2014/10/23/medline KW - ASD KW - Aggression KW - Aripiprazole KW - Developmental disabilities KW - Intellectual disabilities KW - Problem behaviour KW - Self-injurious behaviour SP - 711 EP - 25 JF - Research in developmental disabilities JO - Res Dev Disabil VL - 35 IS - 3 N2 - The management of problem behaviours (PB) in individuals with intellectual disabilities (ID), developmental disabilities (DD) and/or autistic spectrum disorders (ASD) can be challenging. Antipsychotic medications are commonly prescribed where other strategies have failed. A systematic review (SR) was conducted to establish the research evidence for the efficacy of aripiprazole in the management of PB in adults and children with ID, DD and/or ASD. Although included studies supported the efficacy of aripiprazole for this indication, the overall quality of studies was poor. Of the 20 studies included in this systematic review there were only two randomised controlled trials (RCTs) on children with ASD and/or ID/DD, both of which were conducted by the pharmaceutical company that manufactures aripiprazole, and it is not clear whether a number of same participants were included in both RCTs. One of the RCTs was extended into an open label long term follow up, which showed that aripiprazole's efficacy lasted over 52 weeks and the adverse effects were tolerable. Four studies were open label prospective studies, 11 were retrospective case reports which included four single case reports, and two were prospective case series. Most studies reported adverse effects from aripiprazole in the form of weight gain, increased appetite, sedation, tiredness, drooling and tremor. However, aripiprazole improved serum prolactin level in some participants and overall did not show any adverse effect on QTc interval. There is a need for more carefully designed RCTs into the use of aripiprazole in the management of PB in people with ID/DD and/or ASD, which should be carried out independent of pharmaceutical companies. SN - 1873-3379 UR - https://www.unboundmedicine.com/medline/citation/24405794/The_effectiveness_of_aripiprazole_in_the_management_of_problem_behaviour_in_people_with_intellectual_disabilities_developmental_disabilities_and/or_autistic_spectrum_disorder__a_systematic_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0891-4222(13)00547-7 DB - PRIME DP - Unbound Medicine ER -