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Reducing antipsychotic medication in people with a learning disability
1Welsh Centre for Learning Disabilities, University of Wales College of Medicine, Cardiff.
Summary
Antipsychotic drug reduction is feasible for individuals with learning disabilities experiencing behavioral issues. A significant number achieved full withdrawal or substantial reduction, indicating potential for deprescribing.
Area of Science:
- Psychiatry
- Clinical Psychology
- Pharmacology
Background:
- Antipsychotic drug use in individuals with learning disabilities is under scrutiny.
- There is a growing effort to reduce the prescription of these medications.
Purpose of the Study:
- To investigate factors influencing antipsychotic drug reduction.
- To assess the feasibility of reducing antipsychotic medication in people with learning disabilities prescribed for behavioral problems.
Main Methods:
- A randomized controlled trial was conducted.
- The experimental group (n=36) underwent phased, monthly 25% antipsychotic drug reductions.
- The control group (n=20) had no planned drug changes.
Main Results:
- 33% of participants completed full drug withdrawal; 19% achieved at least 50% reduction.
- Drug reduction correlated with increased dyskinesia and activity engagement, but not maladaptive behavior.
- Certain environmental factors were linked to antipsychotic drug reinstatement.
Conclusions:
- A significant proportion of individuals with learning disabilities can reduce or stop antipsychotic medications.
- Deprescribing is a viable option for those with behavioral issues, not solely for psychotic illnesses.