Can my mentally retarded daughter be helped?

QUESTION:

Dear Dr. Heller,

My 24 year old daughter is mentally retarded. she is on Tegretol, Paxil, and Loxapine she has calmed down some. she was placed in a group home yesterday and she became violent. is there anything that I can do to help her/ or something that can be done for her?

ANSWER:

Assuming she has the BPD, the medications are a good choice. It’s very, very difficult working with these mental health diagnoses in someone who is mentally retarded. Making diagnoses is also very difficult. I often recommend that my screening test be taken by both biological parents to look for clues regarding the child’s diagnoses. Attention deficit disorder needs to be looked at as well, because impulsive anger can worsen her condition. The atypical antipsychotics, especially Clozaril, Risperdal and Seroquel may be of significant use as well. I have generally found that high normal blood levels are needed for Tegretol to have it’s maximum effectiveness.