Commentary by Roger Martin Martin writes about research at KU for Kansas media and in a Web zine. Contact Martin at rmartin@kucr.ukans.edu or (785) 864-7239. Martin also can be heard on KANU 91.5 FM public radio Archives More articles by Roger Martin Subscribe now to receive KU News by email

Promising drug may alter disturbing behavior

by Roger Martin

In the past, we treated some forms of upsetting human behavior in upsetting ways. We chained people up, put them in straitjackets, immersed them in icy baths, confined them to asylums.

Government policy in the 1980s put most asylums out of business -- but the upsetting behavior continues.

Case 1. An 11-year-old autistic kid kicks, bites, scratches, pinches. He has, on several occasions, drawn blood from teachers and paraprofessionals.

Case 2. A teacher calls a mother. The daughter has been chewing her hand and wrist again. The mother will say that her daughter's hand looked like "hamburger."

Steve Schroeder, director of the University of Kansas Center on Disabilities, spent years trying to alter behaviors like these without the aid of drugs. But the behaviors would return again and again, with the persistence of a back spasm.

Imbalances in brain chemistry seem to be at their root. Dopamine and serotonin are certainly involved. Other brain chemicals may also be. Nobody knows for sure.

Nevertheless, Schroeder and two KU colleagues, Jennifer Zarcone, a psychologist, and Jessica Hellings, a psychiatrist, have found that a drug that helps schizophrenics can also aid people who strike out at others or tear at their own flesh.

The drug is risperidone. In a program run by the KU researchers, the violent boy and the self-mutilating girl were both helped by the drug. Risperidone works better than such old standbys as Haldol and Thorazine, the researchers report in the November issue of the American Journal on Mental Retardation.

Twenty people in all took the drug. In half the subjects, it reduced self-injury and aggression by 50 percent; in all the other subjects but one, the problems were reduced by 25 percent. The drug's side effects also seem to be less serious than those of Haldol and Thorazine. Thirty more patients now have been admitted into the program. All 50 are highly difficult cases, say Schroeder and Hellings. Many had multiple diagnoses and were taking several drugs to regulate their behavior.

First off, they had to stop taking nearly all other medications. Then, during different phases of the study, they sometimes received liquid risperidone and sometimes a liquid with no drug activity.

Finally the researchers compared the behavior of the patients when they were on and off the medication.

Some parents wouldn't allow their children to join the program because the thought of their being off medication was too daunting.

It's been a dozen years since a consensus statement emerged from a National Institutes of Health conference on the various approaches to treating aggressive and self-injurious behavior.

According to the statement, the wide difference in the responses of individuals to drug therapy was "troubling."

If the KU researchers' findings hold, risperidone offers a more predictable result.

It's clear now that the asylum was never a remedy. Sad to say, hospitalized mental patients with disturbed behavior were imprisoned twice -- once by their own brain chemistry and once again by society.