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People with intellectual disability commonly demonstrate aggressive and challenging behavior. Although this behavior lacks formal diagnostic criteria and has no clear connections to psychosis, it is often treated with antipsychotic drugs; there is little evidence that this treatment is effective or safe.
To evaluate this prescribing practice, researchers in Britain and Australia randomized 86 nonpsychotic adults with intellectual disability (IQ, <75), recent challenging or aggressive behavior, and no recent antipsychotic therapy to receive titrated daily doses of oral risperidone (mean, 1.78 mg), haloperidol (mean, 2.94 mg), or placebo for 8 to 26 weeks. Lorazepam was permitted as rescue medication.
After 4 weeks, aggression decreased similar…