Appropriate and inappropriate use of psychotherapeutic medications for institutionalized mentally retarded persons.

Evaluation of psychiatric treatment in institutions must be based not only on the numbers and types of drugs prescribed but also on diagnoses and other characteristics of the patients. We crosstabulated psychotherapeutic medication regimens against diagnoses for 242 institutionalized mentally retarded adolescents and adults selected for psychiatric treatment. The drugs had generally been prescribed by nonpsychiatrists, but diagnoses were determined by consensus of evaluation teams that included fully trained psychiatrists. According to widely accepted standards for psychopharmacologic treatment, 45.4% to 60.9% of the regimens were rated as appropriate and 39.1% to 54.6% were rated as inappropriate for the conditions diagnosed.

Electroconvulsive treatment of psychotic self-injurious behavior in a patient with severe mental retardation.

This report describes a severely retarded adult patient whose self-injurious behavior became acutely life threatening. Electroconvulsive therapy (ECT) was prohibited by law, but it was administered after the law was judged unconstitutional. The patient's response to ECT was excellent, and there were no adverse consequences.