Practitioner Review: Psychopharmacology in children and adolescents with mental retardation


  • Conflict of interest statement: Grants: Pfizer, Lilly, Janssen, Cerebrus.

Benjamin L. Handen, Merck Child Outpatient Clinic, 1011 Bingham St., Franklin Building, Pittsburgh, PA, USA 15203; Tel: 412–235–5445; Fax: 412–235–5446; Email:


Background:  The use of psychotropic medication to treat children and adults with mental retardation (MR) has a long and extensive history. There are no identified medications to address specific cognitive deficits among persons with MR. Instead, psychotropic medications are used to treat specific behavioral symptoms and/or psychiatric syndromes. The purpose of this review is to provide an overview of the recent literature regarding the use of psychotropic medications in this population, focusing primarily on children and adolescents.

Methods:  The paper is divided into five general drug categories: psychostimulants, antipsychotics, antidepressants, mood stabilizers, and other drugs. Each section offers an overview of the research supporting the use of that class of medications in children and adolescents with MR as well as cautions regarding potential side effects. Finally, specific clinical recommendations are offered.

Results:  The majority of studies in MR tend to be open trials, case reports, or controlled studies with small samples. The available data suggests that persons with MR respond to various psychotropic medications in ways similar to the typically developing population. However, rates of response tend to be poorer and the occurrence of side effects tends to be more frequent.

Conclusions:  The use of psychotropic medications in children and adolescents with MR requires even greater monitoring and the use of lower doses and slower dosage increases than in the general population.