Pharmacological interventions for challenging behaviour in children with intellectual disabilities: a systematic review and meta-analysis

Table 1 Characteristics of included studies

Study	Diagnosis	Targeted CB^a(measure)	Intervention (dose mg/day)	Comparison (dose mg/day)	Treatment duration
Akhondzadeh 2008	ASD	Severely disruptive symptoms (ABC total)	Piracetam (800) + risperidone (3)	Placebo + risperidone (3)	10 weeks
Aman 2002	Mild to moderate ID	Conduct problems (NCBRF conduct)	Risperidone (1.2)	Placebo	6 weeks
Ghanizadeh 2013	ASD	Irritability (ABC-I)	Aripiprazole (5.5)	Risperidone (1.1)	8 weeks
Hardan 2012	ASD	Irritability (ABC-I)	N-acetylcysteine (2700)	Placebo	12 weeks
Hellings 2005	ASD + ID^b	Irritability (ABC-I)	Valproate (20)^c	Placebo	8 weeks
Hollander 2010	ASD^d	Irritability (ABC-I)	Valproate (375)	Placebo	8 weeks
Kent 2013^e	ASD	Irritability (ABC-I)	Risperidone (1.8)^f	Placebo	6 weeks
Malone 2001	ASD + mild to severe ID^g	Hyperactivity (CPRS-H)	Olanzapine (10)^f	Haloperidol (2.5)	6 weeks
Marcus 2009	ASD	Irritability (ABC-I)	Aripiprazole (10)^h	Placebo	8 weeks
Owen 2009	ASD	Irritability (ABC-I)	Aripiprazole (8.9)	Placebo	8 weeks
Rezaei 2010	ASD	Irritability (ABC-I)	Topiramate (200) + risperidone (2)^f	Placebo + risperidone (2)^f	8 weeks
RUPP 2002ⁱ	ASD + mild to severe ID	Irritability (ABC-I)	Risperidone (1.8)	Placebo	8 weeks
Shea 2004	ASD + mild to moderate ID	Conduct problems (NCBRF conduct)	Risperidone (1.5)	Placebo	8 weeks
Snyder 2002	Mild to moderate ID^j	Conduct problems (NCBRF conduct)	Risperidone (1)	Placebo	6 weeks

Notes: ASD = autism spectrum disorder; CB = challenging behaviour; ID = intellectual disability; N = number randomised; ABC total = Aberrant Behaviour Checklist total score; ABC-I = Aberrant Behaviour Checklist: Irritability; CGI-I = Clinical Global Impressions: Improvement; CPRS-H Children’s Psychiatric Rating Scale: Hyperactivity; NCBRF = Nisonger Child Behaviour Rating Form: Conduct problems. ^a Primary outcome measure for meta-analysis; ^b 13 % of sample had borderline to average intelligence; 87 % were diagnosed with ID; ^c 20 mg/kg/day; ^d15% of sample had Asperger’s syndrome; ^e Three armed trial: high dose risperidone and placebo arms used in meta-analysis; ^f Maximum dose; ^g 8 % of participants had normal cognitive functioning, all others had mild to severe ID; ^h Data from high, moderate and low dose conditions combined in meta-analyses; ⁱ Research Units on Pediatric psychopharmacology (RUPP) Autism Spectrum Disorder Network; ^j 2 % of participants had borderline intellectual functioning; all others had mild to moderate ID.

ISSN: 1471-244X