Last Updated on June 21, 2016
A new study to explore the use of psychotropic drugs for people with learning disabilities or mental illness and challenging behaviour in primary care has been published in the BMJ.
Using GP data, the study found that the rate of new antipsychotic prescribing was significantly higher in people with challenging behaviour and a learning disability. Autism, dementia, and older age were also independently associated with antipsychotic use in people with a learning disability.
It concluded that the proportion of people with a learning disability who have been treated with psychotropic drugs far exceeds the proportion with recorded mental illness. Antipsychotics are often prescribed to people without recorded severe mental illness but who have a record of challenging behaviour.
The findings suggest that changes are needed in the prescribing of psychotropics for people with a learning disability. More evidence is needed of the efficacy and safety of psychotropic drugs in this group, particularly when they are used for challenging behaviour.
The study represents the largest and most comprehensive analysis of the associations between mental illness, challenging behaviour, and prescribing of psychotropic drugs in people with a learning disability. It found that more than a third of people with a learning disability had a record of mental illness, including almost 1 in 10 who had a record of severe mental illness. Challenging behaviour was also commonly recorded by GPs.
More than two thirds of people had a record of prescription of any psychotropic drug, and more than a quarter had received an antipsychotic.
Challenging behaviour was independently associated with prescription of antipsychotics suggesting that the drugs are being used to manage challenging behaviour in primary care in some cases. Autism, dementia, and older age were also independently associated with prescription of antipsychotics in people with a learning disability.
This new study echoes one from Public Health England in July, which found that one in six adults with a learning disability is being prescribed antipsychotic drugs by their GP. Over half of these adults do not have a recorded diagnosis of a condition they are designed to treat. https://www.gov.uk/government/news/people-with-learning-disabilities-over-prescribed-psychiatric-drugs
Also, the National Institute of Health and Care Excellence published guidance to move away from the overuse of antipsychotic drugs for people with a learning disability. https://www.caremanagementmatters.co.uk/nice-guidance-addressing-behaviour-that-challenges/
The BMJ study
Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study is available on the BMJ website.
http://www.bmj.com/content/351/bmj.h4326