BACKGROUND: The use of antipsychotic drugs in people with learning disabilities is currently receiving intensified scrutiny and attempts are being made to reduce it. AIMS: A randomised controlled trial was designed to investigate factors influencing antipsychotic drug reduction among people with learning disabilities prescribed such medication for behavioural problems. METHOD: Thirty-six participants randomly allocated to the experimental group underwent four, monthly 25% drug reduction stages. There were no planned drug changes for the control group (n = 20). RESULTS: Twelve participants (33%) completed full withdrawal; a further seven (19%) achieved and maintained at least a 50% reduction. Drug reduction was associated with increased dyskinesia and higher activity engagement but not increased maladaptive behaviour. Some setting characteristics were associated with drug reinstatement. CONCLUSIONS: A substantial proportion of people with learning disability prescribed antipsychotic medications for behavioural purposes rather than for treating psychotic illness can have their drugs reduced or withdrawn.
RCT Entities:
BACKGROUND: The use of antipsychotic drugs in people with learning disabilities is currently receiving intensified scrutiny and attempts are being made to reduce it. AIMS: A randomised controlled trial was designed to investigate factors influencing antipsychotic drug reduction among people with learning disabilities prescribed such medication for behavioural problems. METHOD: Thirty-six participants randomly allocated to the experimental group underwent four, monthly 25% drug reduction stages. There were no planned drug changes for the control group (n = 20). RESULTS: Twelve participants (33%) completed full withdrawal; a further seven (19%) achieved and maintained at least a 50% reduction. Drug reduction was associated with increased dyskinesia and higher activity engagement but not increased maladaptive behaviour. Some setting characteristics were associated with drug reinstatement. CONCLUSIONS: A substantial proportion of people with learning disability prescribed antipsychotic medications for behavioural purposes rather than for treating psychotic illness can have their drugs reduced or withdrawn.
Authors: Shoumitro Deb; Henry Kwok; Marco Bertelli; Luis Salvador-Carulla; Elspeth Bradley; Jennifer Torr; Jarret Barnhill Journal: World Psychiatry Date: 2009-10 Impact factor: 49.548
Authors: Bas Kleijwegt; Addy Pruijssers; Lydie de Jong-Bakker; Koos de Haan; Harmieke van Os-Medendorp; Berno van Meijel Journal: J Appl Res Intellect Disabil Date: 2019-02-20
Authors: Shoumitro Deb; Tom Nancarrow; Bharati Limbu; Rory Sheehan; Mike Wilcock; David Branford; Ken Courtenay; Bhathika Perera; Rohit Shankar Journal: BJPsych Open Date: 2020-09-17