Reducing antipsychotic medication in people with a learning disability.
BACKGROUND
The use of antipsychotic drugs in people with learning disabilities is currently receiving intensified scrutiny and attempts are being made to reduce it.


OBJECTIVE
A randomised controlled trial was designed to investigate factors influencing antipsychotic drug reduction among people with learning disabilities prescribed such medication for behavioural problems.


METHODS
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medications for behavioural purposes rather than for treating psychotic illness can have their drugs reduced or withdrawn.
Ahmed
Z
Z
Welsh Centre for Learning Disabilities, University of Wales College of Medicine, Cardiff.
Fraser
W
W
Kerr
M P
MP
Kiernan
C
C
Emerson
E
E
Robertson
J
J
Felce
D
D
Allen
D
D
Baxter
H
H
Thomas
J
J
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D001519:Behavior; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000188:drug therapy*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies
D014150:Antipsychotic Agents