title: Reducing antipsychotic medication in people with a learning disability.
abstract: 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medications for behavioural purposes rather than for treating psychotic illness can have their drugs reduced or withdrawn.
authors.affiliation: Welsh Centre for Learning Disabilities, University of Wales College of Medicine, Cardiff.
authors.forename: Z
authors.initials: Z
authors.lastname: Ahmed
authors.forename: W
authors.initials: W
authors.lastname: Fraser
authors.forename: M P
authors.initials: MP
authors.lastname: Kerr
authors.forename: C
authors.initials: C
authors.lastname: Kiernan
authors.forename: E
authors.initials: E
authors.lastname: Emerson
authors.forename: J
authors.initials: J
authors.lastname: Robertson
authors.forename: D
authors.initials: D
authors.lastname: Felce
authors.forename: D
authors.initials: D
authors.lastname: Allen
authors.forename: H
authors.initials: H
authors.lastname: Baxter
authors.forename: J
authors.initials: J
authors.lastname: Thomas
mesh_terms: 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
chemical_list: D014150:Antipsychotic Agents