The effect of buspirone on challenging behaviour in mentally retarded patients: an open prospective multiple-case...

During the past few decades, suggestive evidence has been accumulated that abnormalities in serotonin neurotransmission are involved in the pathogenesis of aggressive behaviour disorders and impulsivity. Support for this idea can be derived from clinical studies using 5-HT1 agonistic compounds and serotonergic antidepressants. In the present study, the efficacy of the 5-HT1a agonist buspirone was investigated in eight patients with mental retardation and severe, long-lasting challenging behaviour, characterized by aggressive outbursts, self-injurious behaviour and impulsivity. The findings demonstrate that buspirone, in a daily dosage varying between 20 and 50 mg, may be effective in reducing this type of behavioural disturbance and associated with an improvement in sociability. It is hypothesized that the responsiveness to buspirone treatment may be the result of a de-arousing phenomenon, mediated via corticosteroid dependent stress homeostatic mechanisms.