Fwd: NY Times: Drugs Offer No Benefit in Curbing Aggression, Study Finds

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> Date: January 4, 2008 6:28:02 AM PST

> To: alternative-autismhealing

> Subject: [alternative-autismhealing] NY Times: Drugs Offer No

> Benefit in Curbing Aggression, Study Finds

> Reply-To: alternative-autismhealing

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> http://www.nytimes.com/2008/01/04/health/04aggression.html?

> _r=1 & oref=slogin

>

> Drugs Offer No Benefit in Curbing Aggression, Study Finds By

> BENEDICT CAREY

>

> Published: January 4, 2008

> The drugs most widely 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.

>

> The finding, being published Friday, sharply challenges standard

> medical practice in mental health clinics and nursing homes in the

> United States and around the world.

>

> In recent years, many doctors have begun to use the so-called

> antipsychotic drugs, which were developed to treat schizophrenia,

> as all-purpose tranquilizers to settle threatening behavior — in

> children with attention-deficit problems, college students with

> depression, older people with Alzheimer’s disease and

> intellectually handicapped people.

>

> The new study tracked 86 adults with low I.Q.’s in community

> housing in England, Wales and Australia over more than a month of

> treatment. It found a 79 percent reduction in aggressive behavior

> among those taking dummy pills, compared with a reduction of 65

> percent or less in those taking antipsychotic drugs.

>

> The researchers focused on two drugs, Risperdal by Janssen, and an

> older drug, Haldol, but said the findings almost certainly applied

> to all similar medications. Such drugs account for more than $10

> billion in annual sales, and research suggests that at least half

> of all prescriptionsare for unapproved “off label” uses — often to

> treat aggression or irritation.

>

> The authors said the results were quite likely to intensify calls

> for a government review of British treatment standards for such

> patients, and perhaps to prompt more careful study of treatment for

> aggressive behavior in patients with a wide variety of diagnoses.

>

> Other experts said the findings were also almost certain to inflame

> a continuing debate over the widening use of antipsychotic drugs.

> Patient advocates and some psychiatrists say the medications are

> overused.

>

> Previous studies of the drugs’ effect on aggressive outbursts have

> been mixed, with some showing little benefit and others a strong

> calming influence. But the drugs have serious side effects,

> including rapid weight gain and tremors, and doctors have had

> little rigorous evidence to guide practice.

>

> “This is a very significant finding by some very prominent

> psychiatrists” — one that directly challenges the status quo, said

> 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.

>

> While it is unclear how much the study by itself will alter

> prescribing habits, “the message to doctors should be, think twice

> about prescribing, go with lower doses and monitor side effects

> very carefully,” Dr. Matson continued, adding:

>

> “Or just don’t do it. We know that behavioral treatments can work

> very well with many patients.”

>

> Other experts disagreed, saying the new study was not in line with

> previous research or their own experience. Janssen, a &

> subsidiary, said that Risperdal only promotes approved

> uses, which in this country include the treatment of irritability

> associated with autism in children.

>

> In the study, Dr. J. Tyrer, a professor of psychiatry at

> Imperial College London, led a research team who assigned 86 people

> from ages 18 to 65 to one of three groups: one that received

> Risperdal; one that received another antipsychotic, the generic

> form of Haldol; and one that was given a placebo pill. Caregivers

> tracked the participants’ behavior. Many people with very low

> I.Q.’s are quick to anger and lash out at others, bang their heads

> or fists into the wall in frustration, or singe the air with

> obscenities when annoyed.

>

> After a month, people in all three groups had settled down, losing

> their temper less often and causing less damage when they did. Yet

> unexpectedly, those in the placebo group improved the most,

> significantly more so than those on medication.

>

> In an interview, Dr. Tyrer said there was no reason to believe that

> any other antipsychotic drug used for aggression, like Zyprexa from

> Eli Lilly or Seroquel from AstraZeneca, would be more effective.

> Being in the study, with all the extra attention it brought, was

> itself what apparently made the difference, he said.

>

> “These people tend to get so little company normally,” Dr. Tyrer

> said. “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.”

>

> The study authors, who included researchers from the University of

> Wales and the University of Birmingham in Britain and the

> University of Queensland in Brisbane, Australia, wrote that their

> 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 the drugs for aggression, they

> concluded, “should no longer be regarded as a satisfactory form of

> care.”

>

>

> ____________________________________

> " Imagination is more important than knowledge. " - Albert Einstein

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