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A structured programme to withdraw antipsychotics among adults with intellectual disabilities: The Cornwall
Rohit Shankar1,2, Mike Wilcock3, Shoumitro Deb4
1Cornwall Partnership NHS Foundation Trust, Truro, UK.
Summary
Antipsychotic withdrawal is feasible in adults with intellectual disabilities. A structured, collaborative approach successfully reduced or stopped antipsychotic use in over half of participants without adverse outcomes.
Area of Science:
- Neuroscience
- Psychiatry
- Intellectual Disabilities Research
Background:
- Antipsychotic medication is frequently prescribed for challenging behaviors in adults with intellectual disabilities, often exceeding recommended guidelines.
- Current evidence suggests antipsychotic withdrawal or dose reduction is possible in a significant proportion of this population.
Purpose of the Study:
- To develop and evaluate a structured pathway for antipsychotic withdrawal in adults with intellectual disabilities.
- To assess the feasibility and outcomes of a collaborative, multidisciplinary approach to medication reduction.
Main Methods:
- A three-year structured pathway was developed and implemented in Cornwall.
- The pathway involved collaboration between individuals with intellectual disabilities, their carers, General Practitioners (GPs), community learning disability teams, and pharmacists.
Main Results:
- Complete antipsychotic withdrawal was achieved in 46.5% (33/71) of participants.
- A dose reduction of over 50% was achieved in an additional 11.3% (8/71) of participants.
- No hospital admissions or changes in placement were required at three-month follow-up.
Conclusions:
- A concerted, stakeholder-involved effort facilitates successful antipsychotic withdrawal or reduction in adults with intellectual disabilities.
- This approach demonstrates the potential for improving medication management and patient outcomes in this population.
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