UK psychiatrists’ experience of withdrawal of antipsychotics prescribed for challenging behaviours in adults with intellectual disabilities and/or autism
Date
2020-09Author
Subject
Metadata
Show full item recordAbstract
<jats:sec id="S2056472420000976_sec_a1" sec-type="other"> <jats:title>Background</jats:title> <jats:p>A high proportion of adults with intellectual disabilities are prescribed off-licence antipsychotics in the absence of a psychiatric illness. The National Health Service in England launched an initiative in 2016, ‘Stopping over-medication of people with a learning disability [intellectual disability], autism or both’ (STOMP), to address this major public health concern.</jats:p> </jats:sec> <jats:sec id="S2056472420000976_sec_a2" sec-type="other"> <jats:title>Aims</jats:title> <jats:p>To gain understanding from UK psychiatrists working with adults with intellectual disabilities on the successes and challenges of withdrawing antipsychotics for challenging behaviours.</jats:p> </jats:sec> <jats:sec id="S2056472420000976_sec_a3" sec-type="methods"> <jats:title>Method</jats:title> <jats:p>An online questionnaire was sent to all UK psychiatrists working in the field of intellectual disability (estimated 225).</jats:p> </jats:sec> <jats:sec id="S2056472420000976_sec_a4" sec-type="results"> <jats:title>Results</jats:title> <jats:p>Half of the 88 respondents stated that they started withdrawing antipsychotics over 5 years ago and 52.3% stated that they are less likely to initiate an antipsychotic since the launch of STOMP. However, since then, 46.6% are prescribing other classes of psychotropic medication instead of antipsychotics for challenging behaviours, most frequently the antidepressants. Complete antipsychotic discontinuation in over 50% of patients treated with antipsychotics was achieved by only 4.5% of respondents (<jats:italic>n</jats:italic> = 4); 11.4% reported deterioration in challenging behaviours in over 50% of patients on withdrawal and the same proportion (11.4%) reported no deterioration. Only 32% of respondents made the diagnosis of psychiatric illness in all their patients themselves. Family and paid carers’ concern, lack of multi-agency and multidisciplinary input and unavailability of non-medical psychosocial intervention are key reported factors hampering the withdrawal attempt.</jats:p> </jats:sec> <jats:sec id="S2056472420000976_sec_a5" sec-type="conclusions"> <jats:title>Conclusions</jats:title> <jats:p>There is an urgent need to develop national guidelines to provide a framework for systematic psychotropic drug reviews and withdrawal where possible.</jats:p> </jats:sec>
Collections
Publisher
Place of Publication
Journal
Volume
Issue
Pagination
Number
Recommended, similar items
The following license files are associated with this item: