Lithium carbonate in the management of hyperactive aggressive behavior of the mentally retarded
| Autor: | Frederic Grunberg, Bernard Berkowitz, Ugo Goetzl |
|---|---|
| Rok vydání: | 1977 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Bipolar Disorder Adolescent Lithium (medication) Psychomotor agitation Poison control Hyperkinesis Lithium chemistry.chemical_compound Rating scale Intellectual Disability medicine Humans Psychiatric hospital Psychiatry Psychomotor learning Lithium carbonate medicine.disease Aggression Psychiatry and Mental health Clinical Psychology Mood disorders chemistry Female medicine.symptom Psychology medicine.drug |
| Zdroj: | Comprehensive Psychiatry. 18:599-606 |
| ISSN: | 0010-440X |
| DOI: | 10.1016/s0010-440x(97)90013-4 |
| Popis: | NE OF THE MOST vexing problems in the management of young and adult retardates, whether in institutions or in the community, is their hyperactive and aggressive behavior. Recently several studies in the literature have reported the use of lithium carbonate in controlling such behavior. Some of those studies have described the indications for lithium therapy in regulating cyclical mood disorders while others described the symptomatic effect of the medication in controlling aggressiveness, restlessness, hyperactivity and other behavioral problems independent of an affective disorder. Adams et al.’ reported the case of an 18 year old mildly retarded female adolescent with a well-documented history of manic depressive illness. They also reported that the psychomotor hyperactivity during her last manic episode was well controlled by lithium but the authors did not report the dose, the serum levels of lithium, or the duration of treatment. Dostal and Zvolsky” reported the effects of lithium therapy on 14 severely mentally retarded adolescents hospitalized in a special unit at the University Psychiatric Hospital in Prague for aggressive and hyperactive behavior resistant to phenothiazines. The study, which lasted eight months, was divided into three phases. During the first phase, of three months duration, while still under phenothiazine medication, the patients were given slow-releasing tablets of lithium which produced an average serum lithium level of 0.3 meq/liter. During the second phase, which lasted one month, the phenothiazines were discontinued and lithium was raised to a mean serum lithium level of 0.6 meq/liter. The third phase, the actual therapeutic period, lasting four months, consisted of raising the average serum lithium level to 0.92 meq/liter. Throughout the eight months clinical trial, the patients were rated on a monthly basis by two independent raters using a special rating scale (the Cerny rating scale). In addition, all the acute aggressive episodes were reported and computed by the nursing staff. Comparing the average scores during the last phase (the lithium therapeutic phase) with those of the first and second phases (the pretherapeutic phases) a statistically significant improvement was noted on the following items: affectivity, aggressivity, psychomotor activity, restlessness, and undisciplined behavior. The authors report that of 12 patients with “positive affective symptomatology,” all but one improved on lithium. |
| Databáze: | OpenAIRE |
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