Risperdal, Haldol, other Antipsychotic Drugs Little Help in Managing Aggression

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Risperdal, Haldol and other Antipsychotic Drugs Little Help in

Managing Aggression

Date Published: Friday, January 4th, 2008

Antipsychotic drugs used to manage aggressive outbursts in

intellectually disabled people are no more effective than placebos

for most patients and may be less so, researchers report, challenging

established worldwide medical practice. Researchers focused on

Janssen's Risperdal and Haldol but said findings applied to similar

medications such as Zyprexa. These drugs account for over $10

billion in annual sales and at least half of all prescriptions are

for unapproved off label uses to treat aggression or irritation.

While it is illegal for drug companies to market approved medications

for off label uses, how a drug is used remains at the prescribing

physician's discretion; many use antipsychotics—developed for

schizophrenia—as tranquilizers for children with attention-deficit

problems, college students with depression, Alzheimer's patients, and

intellectually handicapped people.

The study tracked 86 adults—aged 18 to 65—with low IQs living in

community housing in England, Wales, and Australia for more than a

month and found a 79 percent reduction in aggressive behavior among

those on placebos as compared to a 65 percent or less reduction in

those on antipsychotics. Dr. J. Tyrer, professor of psychiatry

at Imperial College London, led the team. Patients were given

Risperdal, Haldol, or a placebo and behavior was tracked—many with

very low IQs tend to lash out at others and themselves quickly.

Patients in all three groups improved; those on the placebo improved

significantly compared to those on medication.

Researchers said the results would likely spur requests for

government review of British treatment standards. Others feel these

findings will add to the continuing debate over the widening use of

antipsychotic drugs and patient advocates and some psychiatrists feel

the medications are overused. While studies have been mixed, the

drugs do have serious side effects and doctors have little to guide

them. ny L. Matson, a professor of psychology at Louisiana State

University in Baton Rouge, co-author of an editorial with the study

in the journal Lancet said, " The message to doctors should be, think

twice about prescribing or just don't do it. We know that behavioral

treatments can work very well with many patients. " Others disagreed,

saying the study did not reflect previous research or their

experience. Janssen, a & subsidiary, said Risperdal

only promotes approved uses, which in Great Britain, includes

treating autism-related irritability. Tyrer said there was no reason

to believe other antipsychotics used for aggression, like Zyprexa

from Eli Lilly or Seroquel from AstraZeneca, would be more

effective. " These people tend to get so little company normally,

they're neglected, they tend to be pushed into the background and

this extra attention has a much bigger effect on them that it would

on a person of more normal intelligence level, " said Tyler.

Study authors included researchers from the University of Wales and

the University of Birmingham in Britain and the University of

Queensland in Brisbane, Australia. Authors claim results " should not

be interpreted as an indication that antipsychotic drugs have no

place in the treatment of some aspects of behavior disturbance, " but

the routine prescription of drugs for aggression " should no longer be

regarded as a satisfactory form of care. "