Antipsychotic medication for challenging behaviour in people with learning disability.
BACKGROUND
The term 'challenging behaviour', in the absence of psychiatric disorder, encompasses a wide range of behaviours that may be harmful to people or property, may be difficult to manage and may limit access to community facilities. Antipsychotic medications have been used to modify such behaviours in people with learning disability, but there is little evidence to suggest that the benefits outweigh the risks.


OBJECTIVE
To determine the effectiveness of antipsychotic medication for people with learning disability and challenging behaviour without additional mental illness.


METHODS
Biological Abstracts, the Cochrane Library, EMBASE, MEDLINE and PsycINFO were searched. Further references were sought from published trials and pharmaceutical companies. Trials were reliably identified and data extracted.


METHODS
All randomised controlled trials of antipsychotic medication versus placebo.


METHODS
Reviewers independently evaluated and analysed data on an intention to treat basis. Data were evaluated at 4 and 8 weeks as longer follow-up data were not available. Reviewers assumed that those subjects lost to follow-up had a bad outcome.


RESULTS
Only eight randomised controlled trials could be included in the analyses. These provided no evidence of whether antipsychotic medication helps or harms adults with learning disability and challenging behaviour.


CONCLUSIONS
There are limited data on this important issue and more research is urgently needed.
Brylewski
J
J
Oxfordshire Learning Disability Trust, Slade House, Horspath Driftway, Headington, Oxford, UK, OX3 7JH. Jane.b@btinternet.com
Duggan
L
L
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001526:Behavioral Symptoms / Q000188:drug therapy; D003617:Dangerous Behavior; D006801:Humans; D007859:Learning Disabilities / Q000150:complications*; D016032:Randomized Controlled Trials as Topic; D012306:Risk
D014150:Antipsychotic Agents