Psychopharmacological treatment of challenging behaviours in adults with autism and intellectual disabilities: A systematic review

• Adults with Autism and intellectual disability commonly have challenging behaviours.
• Summary of the psychopharmacological treatment of challenging behaviours in this population.
• Fluvoxamine and risperidone have randomized controlled trials showing efficacy.
• Sertraline clomipramine and ziprasidone have open label trials showing their efficacy.

IntroductionAutism is a neurodevelopmental disorder with a high co-occurrence with intellectual disability. Adults with Autism and intellectual disability have a high incidence of challenging behaviour, defined as repetitive self injurious or aggressive behaviour. We underwent a systemic review of the evidence for treating challenging behaviours in adults with Autism and intellectual disability.MethodsA literature search was conducted using three large databases to extract studies on the treatment of challenging behaviour among adults with Autism and intellectual disability. Papers, which met this criterion, were reviewed and analysed to assess study evidence and quality.ResultsSeven articles were selected which included five agents: fluvoxamine, sertraline, clomipramine, risperidone, and ziprasidone. Randomized control studies of fluvoxamine and risperidone, provided efficacy for the treatment of challenging behaviour in adults with Autism and intellectual disability. Open label trials of sertraline, clomipramine and ziprasidone were also effective in treating challenging behaviours for this population.DiscussionRisperidone and fluvoxamine provided the best evidence for treating challenging behaviour, and risperidone was the only medication with multiple trials showing its efficacy. Further studies are required to demonstrate the efficacy of psychopharmacology in treating challenging behaviours among adults with Autism and intellectual disability.