Faculty Bibliography

Comprehensive clinical evaluation of tics includes (1) assessments to diagnose (a) akathisia, myoclonus, stereotypies, and other dyskinesias and (b) their frequent behavioral concomitants, including attention deficits, compulsions, obsessions, and other psychopathologic manifestations, (2) descriptions of movement parameters from the patients, their parents, teachers, and important others, and (3) precise topographical localization of tics

Post June 15, 2001. Although dopamine antagonists (are often administered to people with mental retardation (MR), the neuropsychiatric effects are controversial. This study sought to characterize the effect of dopamine antagonists (neuroleptics) on movements and behaviors of persons with MR. Dyskinesias, inattention, and behavioral problems such as aggression were assessed in 9 adults with MR referred to psychiatric clinics, including 5 men treated with dopamine antagonists in a dosage range equivalent to 67-220 mg chlorpromazine, and 2 men and 2 women who had received no medication during the preceding 3 mo. The nonmedicated Ss showed higher levels of akathisia, stereotypies, tics, and other dyskinesias and lower global adaptive functioning. Utilizing the Mann-Whitney Test, nonmedicated Ss had more tics (P < .006), attention deficit disorder (P < .018), and overt aggression (P < .015); however, the Bonferroni correction for multiple comparisons rendered all results nonsignificant. It is concluded that dopamine antagonists ameliorate the dyskinesias, aggression, and inattention of some persons with MR and behavioral problems. However, beneficial effects of dopamine antagonists must be weighed against adverse effects, including withdrawal and tardive dyskinesias.