Pharmacological Intervention for Disruptive Behaviors in Intellectual and Developmental Disabilities: The Glass is Half Full

The use of psychotropic medicine for the treatment of disruptive behaviors such as irritability, attention-deficit hyperactivity disorder symptoms, and self-injury is more. common in individuals with intellectual and developmental disabilities (IDD) than in neurotypical populations. With the exception of some atypical antipsychotics, few drugs carry clinical indications for such use. Thus, many children and adults with IDD receive "off-label" medication with varying degrees of empirical support for safety and efficacy. In this chapter, we review the literature on pharmacologic treatment of disruptive behavior in IDD between 2001 and 2010. We discuss several drug classes, including antipsychotics, antidepressants, psychostimulants, norepinephrine reuptake inhibitors, anticonvulsants, and glutamatergic agents. Due to the relative preponderance of research in samples with autism spectrum disorders, we present these separately from studies in general IDD samples. Overall, the research base is strongest for atypical antipsychotics and psychostimulants, and it is clear that the field has advanced between 2001 and 2010. Other drug classes have received relatively little research attention. We identify several areas in which the field can improve future research, including the study of combination treatments (e.g. cotherapy and medication plus behavioral).