BACKGROUND: Clozapine has proven efficacy in the management of treatment-resistant schizophrenia. Additional use in patients with mood and schizoaffective disorders, Parkinson's disease with psychosis, and brain injury has been reported. Preclinical data have suggested its possible utility in treating self-injurious behavior in patients with mental retardation. METHOD: The use of clozapine in six patients with moderate-to-profound mental retardation is described. The issue of diagnosing psychosis in such individuals and its impact on choice of pharmacotherapy is considered. RESULTS: Clozapine in these individuals may have led to a significant reduction in aggression, self-injurious behavior, and psychotic symptoms. Side effects were minimal and similar to those seen in the schizophrenic population. CONCLUSION: These case reports illustrate that clozapine may be useful and well tolerated in the treatment of aggression in patients with moderate-to-profound mental retardation.
BACKGROUND:Clozapine has proven efficacy in the management of treatment-resistant schizophrenia. Additional use in patients with mood and schizoaffective disorders, Parkinson's disease with psychosis, and brain injury has been reported. Preclinical data have suggested its possible utility in treating self-injurious behavior in patients with mental retardation. METHOD: The use of clozapine in six patients with moderate-to-profound mental retardation is described. The issue of diagnosing psychosis in such individuals and its impact on choice of pharmacotherapy is considered. RESULTS:Clozapine in these individuals may have led to a significant reduction in aggression, self-injurious behavior, and psychotic symptoms. Side effects were minimal and similar to those seen in the schizophrenic population. CONCLUSION: These case reports illustrate that clozapine may be useful and well tolerated in the treatment of aggression in patients with moderate-to-profound mental retardation.