Fluoxetine reduced self-injurious behavior in an adolescent with mental retardation

ABSTRACT Self-injurious behavior (SIB) in the mentally retarded population is a poorly understood and often treatment-refractory problem. The behavior, most often manifested by head banging or self-biting, commonly leads to disfigurement and sensory-neural impairment, and its presence often mandates institutional placement. Serotonergic approaches to the modification of SIB can be supported on theoretical grounds, and serotonergic mechanisms have long been considered in the pathogenesis or treatment of specific syndromes of mental retardation with which SIB is associated. This single case study reviews the rationale for serotonergic treatment of SIB, and reports a trial of the serotonin uptake blocker, fluoxetine, for the treatment of SIB associated with nonsyndromal mental retardation. A 19-year-old individual, with an IQ of approximately 40, was treated with fluoxetine 40 mg daily. A clinically significant therapeutic effect was observed on self injurious and other behavioral symptoms, but the reduced frequency and intensity of SIB were found to endure for only about 60-70 days.