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The British Journal of Psychiatry (2000) 176: 42-46
© 2000 The Royal College of Psychiatrists

Reducing antipsychotic medication in people with a learning disability{dagger}

ZAHIR AHMED, MRCPsych, WILLIAM FRASER, MD and MICHAEL P. KERR, MRCPsych

Welsh Centre for Learning Disabilities, University of Wales College of Medicine, Cardiff

CHRIS KIERNAN, PhD, ERIC EMERSON, PhD and JANET ROBERTSON, PhD

Hester Adrian Research Centre, University of Manchester

DAVID FELCE, PhD, DAVID ALLEN, PhD, HELEN BAXTER, MSc and JAMES THOMAS, BSc

Welsh Centre for Learning Disabilities, University of Wales College of Medicine, Cardiff

Correspondence: Z. Ahmed, Welsh Centre for Learning Disabilities, Clinical Studies, Meridian Court, North Road, Cardiff CF4 3 BL

Declaration of interest Funding from the National Research and Development Programme for People with Physical and Complex Disabilities.

{dagger} See editorial pp. 10—11, this issue.

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

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

Method Thirty-six participants randomly allocated to the experimental group under went 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medications for behavioural purposes rather than for treating psychotic illness can have their drugs reduced or withdrawn.




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