Q:  Behavior Problems of a Mentally Disabled Adult & Geodon

My friend is developmentally disabled and just started taking 180mg of the drug Geodon.  He also takes Lamictal 375mg, Topamax 500mg.  Is this drug affective in treating behavior problems for a mentally disabled adult and is it safe to take such a high does.  The doctors we speak to will not give us a clear answer.

Thank you.

Dear Hillary -- 
Just guessing, I'd bet the problem with the lack of clear answers you've been experiencing comes from...the lack of clear answers, sorry to say.  There is extremely little research on treating behavior problems in people with "mentally disabling" conditions.  Most doctors attempting to treat folks with such problems target the symptoms that are causing the most trouble, using medications that have benefited people with similar symptoms -- and unfortunately, that's about as sophisticated as it gets.  So, are these medications effective for your friend's problem?  There is no research to answer the question, which will have to be answered instead by looking at how he does on them.  These are full doses of each medication, high but not excessive.   His doctors will need to be careful not to cause problems with these doses that look like target symptoms for another medication -- e.g. sedation from Geodon or Topomax; or confusion from Topomax or Lamictal.  But otherwise, this is not an unwise strategy based on what we do for other folks with what I would presume are similar symptoms.  Aggressive treatment, we would call it, but not excessive necessarily. 

Dr. Phelps


Published December, 2004