Letters to the Editor
Reply: Atypical Antipsychotic Use in Treating Adolescents and Young Adults
With Developmental Disabilities
Dear Editor:
Thank you for giving us an opportunity to respond to the views of Bradley
and colleagues. We are pleased that they highlighted the complex diagnostic
issues involved in diagnosing Axis I mental disorders in individuals with
developmental disorders (DDs). Prior to arriving at a diagnosis, all behavioural
disorders in this population should be investigated carefully to see whether
they represent nonverbal, indirect communications of distress caused typically
by pain or psychosocial stress.
Our mental health support teams provide a full multidisciplinary evaluation,
and all patients in our sample had behavioural–psychosocial interventions
in addition to psychopharmacological treatment. We intended our paper to
illustrate the widespread use of atypical antipsychotic treatment in clinically
referred youth with DDs and behavioural problems. How much improvement
can be attributed to the atypical antipsychotics is a complex question
that indicates the urgent need for more double-blind placebo-controlled
trials in youth with DDs.
Our study highlights the need for great caution when using these medications
in this population and notes atypical neuroleptic–induced movement disorders
not previously well documented.
Robin Friedlander, MB, ChB, FRCPC
Susan Lazar, MD
Joseph Klancnik, PhD
Vancouver, British Columbia
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