J&J drugs don't work in treating aggression: study

By Michael Kahn

LONDON (Reuters) - Two Johnson & Johnson antipsychotic drugs long used to treat aggressive behavior in people with limited intelligence do not work and should not be prescribed for these patients, researchers said on Friday.

For the past 60 years doctors have treated aggression in people who are not psychotic with the drugs, but placebos seem to do a better job, said Peter Tyrer, a community psychiatrist, who led the study published in UK medical journal The Lancet.

"For most circumstances people shouldn't be given these drugs because there is no indication they work," said Tyrer of Imperial College, London. "What we have shown is the placebo is the most effective component."

About 1.5 percent of the population have IQ's below 70 and are defined as disabled because of their lower intelligence, Tyrer said. These people have difficulty expressing themselves and are often aggressive when trying to do so.

Writing in a commentary in The Lancet, a pair of U.S. 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.

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 much to the debate on a highly vulnerable group.

"Tyrer and colleagues present an important study on a prominent topic in mental health," Johnny Matson and Jonathan Wilkins of the Department of Psychology at Louisiana State University wrote.

Tyrer and colleagues 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 Britain and Australia.

Risperidone is sold under the brand name Risperdal, a top-selling schizophrenia drug. Haloperidol is an older drug which Johnson & Johnson markets as Haldol.

Johnson & Johnson, which sells the drugs through a subsidiary, had no immediate comment.

They found that 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 said.

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, Tyrer said in a telephone interview.

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 added.

"The main effect is the people just don't feel right on them, or comfortable with them" Tyrer said.

(Reporting by Michael Kahn; Editing by Julie Steenhuysen and Erica Billingham)