Case Report: The Effects of Selective Serotonergic Reuptake Inhibitors Combined with Behavioral Treatment on Self-Injury Associated with Lesch-Nyhan Syndrome

Authors: Kirkpatrick-Sanchez S.¹; Williams D.E.¹; Gualtieri C.T.²; Raichman J.A.³

Source: Journal of Developmental and Physical Disabilities, Volume 10, Number 3, September 1998 , pp. 283-290(8)

Publisher: Springer

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Abstract:

A 6-year-old African-American male child with Lesch-Nyhan syndrome participated. Because of the occurrence of unmanageable self-injurious behavior (SIB) in a group home, “James” at the age of 3.5 years was admitted to a large residential facility for persons with mental retardation. A behavior treatment program was implemented soon after admission and produced a large decrease in SIB; however, rates of SIB remained clinically unacceptable and a danger to him. The program consisted of differential reinforcement, extinction, and noncontingent protective restraint. Because SIB may be caused by decreased serotonergic activity, open trials of serotonergic drugs in combination with a serotonergic diet were conducted. The use of a serotonergic diet alone resulted in no change in SIB. Dose-dependent reductions in SIB occurred during paroxetine and sertraline phases, suggesting some benefit in the use of serotonergic drugs.

Keywords: self-injury; Lesch-Nyhan; selective serotonergic reuptake inhibitors

Language: English

Document Type: Research article

Affiliations: 1: Richmond State School, 2100 Preston St., Richmond, Texas 77469-1499 2: North Carolina Neuropsychiatry 3: Psychiatric Center of Houston

Publication date: 1998-09-01