Case Report
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Successful Management of Aggression with Low-Dose Propranolol in an Adolescent Patient with Intellectual Disability: A Case Report

Year 2017, Volume: 8 Issue: 32, 34 - 38, 31.12.2017
https://doi.org/10.17944/mkutfd.345933

Abstract

The risk of accompanying aggression in children with
Intellectual disability is known to be higher than in healthy children.
Aggression in subjects with ID can severely impact on individuals' social
adaptation and education and on the quality of life of caregivers. Aggression
may be verbal or physical. Various agents are used as antiaggressive drugs,
including lithium, anticonvulsants and antipsychotics, although data regarding
the effectiveness of these are limited. It is shown that propranonol is effective
in the treatment of aggression.



This
report describes the successful management with propranolol of aggressive and
self-mutilative behaviors in an adolescent with severe ID.

References

  • Referans1. Erman H, Anlar B. Zihinsel Gelişim (Zeka) Gerilikleri. Çocuk ve Ergen Psikiyatrisi Temel Kitabı içinde. 1.baskı. Ankara, Hekimler Yayın Birliği; 2008. p. 187-98. (Turkish). Referans2. Emerson E, Einfeld S, Stancliffe RJ. The mental health of young children with intellectual disabilities or borderline intellectual functioning. Soc Psychiat Epidemiol. 2010;45:579–87.
  • Referans3. Deb S, Kwok H, Bertelli M, Salvador-Carulla L, Bradley E, Torr J, et al. Guideline Development Group of the WPA Section on Psychiatry of Intellectual Disability. International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities. World Psychiatry. 2009;8(3):181–6.
  • Referans4. Brylewski J, Duggan L. Antipsychotic medication for challenging behaviour in people with learning disability. Cochrane Database Syst Rev. 2004;(3):CD000377.
  • Referans5. Unwin GL, Deb S. Use of medication for the management of behavior problems among adults with intellectual disabilities: a clinicians’ consensus survey. Am J Ment Retard. 2008;113(1):19–31.
  • Referans6. Ratey JJ, Mikkelsen EJ, Smith GB, Upadhyaya A, Zuckerman HS, Martell D, et al. Beta-blockers in the severely and profoundly mentally retarded. J Clin Psychopharmacol. 1986;6(2):103–7.
  • Referans7. Ruedrich SL, Grush L, Wilson J. Beta adrenergic blocking medications for aggressive or self-injurious mentally retarded persons. Am J Ment Retard. 1990;95(1):110–9.
  • Referans8. McClintock K, Hall S, Oliver C. Risk markers associated with challenging behaviours in people with intellectual disabilities: A meta-analytic study. Journal of IntellectualDisability Research. 2003;47:405–16.
  • Referans9. Baumeister AA, SevinJA. Pharmacologic control of aberrant behaviour in the mentally retarded: Toward a more rational approach. Neuroscience & Biobehavioural Reviews. 1990;14:253–326.
  • Referans10. Connor DF, Ozbayrak KR, Benjamin S, Yusheng MA, Fletcher KE. A pilot study of nadolol for overt aggression in developmentally delayed individuals. Journal of the American Academy of Child and Adolescent Psychiatry. 1997;36(6):826–34.
  • Referans11. Calamari JE, McNally RJ, Benson DS, Babington CM. Use of propanolol to reduce aggressive behaviour in a woman who is mentally retarded: Case study. Behavioural Interventions. 1990;5(4):287–96.
  • Referans12. Lang C, Remington D. Treatment with propanolol of severe self-injurious behaviour in a blind, deaf, retarded adolescent. Journal of the American Academy of Child and Adolescent Psychiatry. 1994;33(2):265–9.
  • Referans13. Ruedrich SL. Beta-adrenergic blocking medications for aggressive or self-injurious mentally retarded persons. American Journal of Mental Retardation. 1990;95(1):110–9.
  • Referans14. Luchins DJ, Dojka MS. Lithium and propanolol in aggression and self-injurious behaviour in the mentally retarded. Psychopharmacology Bulletin. 1989;25(3):372–5.
  • Referans15. Kastner T, Burlingham K, Friedman DL. Metoprolol for aggressive behaviors in person s wi rh mental retardation. Am Pam Physician. 1990;42(6):1585-8.
  • Referans16. Ratey J. Mikkelsen E. Sorgi P, Zuckerman HS, Polakoff S, Bemporad J, et al. Autism: the treatment of aggressive behaviors. j Clin Psychophann acoI. 1987;7:35-41.
  • Referans17. Jenkin s SC, Marura T. Therapeutic use of propranolol for intermittent explosive disorders. Mayo Clin Proc. 1987;62(3):204-14.
  • Referans18. Williams DT, Mehl R, Yudofsky S, Adams D, Roseman B. The effect of propranolol on uncontrolled rage outbursts in children and adolescents with organic brain dysfunction. j Am Acad Child AdolescPsychiatry. 1982;2(1):129-35.
  • Referans19. Chrıs Lang MB, Debra Remıngton RN, MSN. Treatment with Propranolol of Severe Self-Injurious Behavior in a Blind,Deaf, Retarded Adolescent.j Am Acad Child AdolescPsychiatry. 1994;33(2):265-9.

Zihinsel Engelliliği Olan Bir Ergende Düşük Doz Propranolol ile Agresyonun Başarılı Tedavisi: Bir Olgu Sunumu

Year 2017, Volume: 8 Issue: 32, 34 - 38, 31.12.2017
https://doi.org/10.17944/mkutfd.345933

Abstract

Saldırganlığın, zihinsel engelliliği (ZE) olan çocuklarda
eşlik etme riskinin sağlıklı çocuklardan daha yüksek olduğu bilinmektedir. ZE olan
kişilerde saldırganlık, bireylerin sosyal uyum ve eğitimi ile bakım verenin
yaşam kalitesi üzerinde ciddi etkiler yapabilmektedir. Saldırganlık sözel veya
fiziksel olabilmektedir. Lityum, antikonvülzanlar ve antipsikotikler gibi
çeşitli antiagresif ilaçlar kullanılmaktadır, ancak bunların etkinliği ile
ilgili veriler sınırlıdır. Propranololün saldırganlığın tedavisinde etkili
olduğu gösterilmiştir.
Bu yazıda
ağır derecede zihinsel engelliği olan bir ergende saldırgan ve yıkıcı
davranışların, propranolol ile başarılı bir şekilde tedavisi anlatılmıştır.

References

  • Referans1. Erman H, Anlar B. Zihinsel Gelişim (Zeka) Gerilikleri. Çocuk ve Ergen Psikiyatrisi Temel Kitabı içinde. 1.baskı. Ankara, Hekimler Yayın Birliği; 2008. p. 187-98. (Turkish). Referans2. Emerson E, Einfeld S, Stancliffe RJ. The mental health of young children with intellectual disabilities or borderline intellectual functioning. Soc Psychiat Epidemiol. 2010;45:579–87.
  • Referans3. Deb S, Kwok H, Bertelli M, Salvador-Carulla L, Bradley E, Torr J, et al. Guideline Development Group of the WPA Section on Psychiatry of Intellectual Disability. International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities. World Psychiatry. 2009;8(3):181–6.
  • Referans4. Brylewski J, Duggan L. Antipsychotic medication for challenging behaviour in people with learning disability. Cochrane Database Syst Rev. 2004;(3):CD000377.
  • Referans5. Unwin GL, Deb S. Use of medication for the management of behavior problems among adults with intellectual disabilities: a clinicians’ consensus survey. Am J Ment Retard. 2008;113(1):19–31.
  • Referans6. Ratey JJ, Mikkelsen EJ, Smith GB, Upadhyaya A, Zuckerman HS, Martell D, et al. Beta-blockers in the severely and profoundly mentally retarded. J Clin Psychopharmacol. 1986;6(2):103–7.
  • Referans7. Ruedrich SL, Grush L, Wilson J. Beta adrenergic blocking medications for aggressive or self-injurious mentally retarded persons. Am J Ment Retard. 1990;95(1):110–9.
  • Referans8. McClintock K, Hall S, Oliver C. Risk markers associated with challenging behaviours in people with intellectual disabilities: A meta-analytic study. Journal of IntellectualDisability Research. 2003;47:405–16.
  • Referans9. Baumeister AA, SevinJA. Pharmacologic control of aberrant behaviour in the mentally retarded: Toward a more rational approach. Neuroscience & Biobehavioural Reviews. 1990;14:253–326.
  • Referans10. Connor DF, Ozbayrak KR, Benjamin S, Yusheng MA, Fletcher KE. A pilot study of nadolol for overt aggression in developmentally delayed individuals. Journal of the American Academy of Child and Adolescent Psychiatry. 1997;36(6):826–34.
  • Referans11. Calamari JE, McNally RJ, Benson DS, Babington CM. Use of propanolol to reduce aggressive behaviour in a woman who is mentally retarded: Case study. Behavioural Interventions. 1990;5(4):287–96.
  • Referans12. Lang C, Remington D. Treatment with propanolol of severe self-injurious behaviour in a blind, deaf, retarded adolescent. Journal of the American Academy of Child and Adolescent Psychiatry. 1994;33(2):265–9.
  • Referans13. Ruedrich SL. Beta-adrenergic blocking medications for aggressive or self-injurious mentally retarded persons. American Journal of Mental Retardation. 1990;95(1):110–9.
  • Referans14. Luchins DJ, Dojka MS. Lithium and propanolol in aggression and self-injurious behaviour in the mentally retarded. Psychopharmacology Bulletin. 1989;25(3):372–5.
  • Referans15. Kastner T, Burlingham K, Friedman DL. Metoprolol for aggressive behaviors in person s wi rh mental retardation. Am Pam Physician. 1990;42(6):1585-8.
  • Referans16. Ratey J. Mikkelsen E. Sorgi P, Zuckerman HS, Polakoff S, Bemporad J, et al. Autism: the treatment of aggressive behaviors. j Clin Psychophann acoI. 1987;7:35-41.
  • Referans17. Jenkin s SC, Marura T. Therapeutic use of propranolol for intermittent explosive disorders. Mayo Clin Proc. 1987;62(3):204-14.
  • Referans18. Williams DT, Mehl R, Yudofsky S, Adams D, Roseman B. The effect of propranolol on uncontrolled rage outbursts in children and adolescents with organic brain dysfunction. j Am Acad Child AdolescPsychiatry. 1982;2(1):129-35.
  • Referans19. Chrıs Lang MB, Debra Remıngton RN, MSN. Treatment with Propranolol of Severe Self-Injurious Behavior in a Blind,Deaf, Retarded Adolescent.j Am Acad Child AdolescPsychiatry. 1994;33(2):265-9.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Report
Authors

Hamza Ayaydın

Fethiye Kılıçaslan

Publication Date December 31, 2017
Submission Date October 23, 2017
Acceptance Date August 7, 2018
Published in Issue Year 2017 Volume: 8 Issue: 32

Cite

Vancouver Ayaydın H, Kılıçaslan F. Successful Management of Aggression with Low-Dose Propranolol in an Adolescent Patient with Intellectual Disability: A Case Report. mkutfd. 2017;8(32):34-8.