For the past 60 years doctors have treated aggression in people who aren't psychotic with the drugs, but placebos seem to do a better job, says Peter Tyrer, a community psychiatrist, who led the study. "For most circumstances people shouldn't be given these drugs because there is no indication they work," Tyrer of Imperial College in London, tells Reuters. "What we have shown is the placebo is the most effective component."
Writing in a commentary in The Lancet, a pair of US researchers said the study was important because of the sparse evidence of how well these drugs work in treating aggression for people with lower-than-normal intelligence, Reuters notes. And while they questioned whether the measures used to assess aggression were sensitive enough to detect the impact of treatment, they said the findings add a great deal to the debate on a highly vulnerable group. That's because the finding runs counter to practices in many mental health clinics and nursing homes. In fact, many docs use these meds as tranquilizers to mitigate aggressive behavior in other populations - kids with ADHD, depressed patients and seniors with Alzheimerâ€™s.
The study measured the effects of the drugs haloperidol and risperidone against a placebo on the aggressive behavior of 86 non-psychotic patients from ten locations in the UK and Australia. The placebo reduced aggression by nearly 80 percent compared with 50 percent to 60 percent for the drugs. The researchers used a widely accepted measuring scale to gauge aggression.
"This is the first study carried out which has not been funded by the pharmaceutical industry and which most of the people have had severe learning disabilities," Tyrer says. One of the reasons the placebo may work so well is the simple psychological effect these often ignored patients gain from the attention of a doctor when given the treatment, he adds
Haloperidol and risperidone cause dry mouth, dizziness, constipation as well as serious side effects such as tremors. These problems likely offset any psychological benefits the drugs would also have, he says. "The main effect is the people just don't feel right on them, or comfortable with them."