Withdrawing Antipsychotics for Challenging Behaviours in Adults with Intellectual Disabilities: Experiences and Views of Prescribers

Gerda de Kuijper (), Joke de Haan, Shoumitro Deb and Rohit Shankar
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Gerda de Kuijper: GGZ-Drenthe/Centre for ID and Mental Health, Middenweg 19, 9404 LL Assen, The Netherlands
Joke de Haan: GGZ-Drenthe/Centre for ID and Mental Health, Middenweg 19, 9404 LL Assen, The Netherlands
Shoumitro Deb: Department of Brain Sciences, Faculty of Medicine, Imperial College London, Du Cane Road, London W12 0NN, UK
Rohit Shankar: Peninsula School of Medicine, University of Plymouth and Cornwall Partnership NHS Foundation Trust, Plymouth PL4 8AA, UK

IJERPH, 2022, vol. 19, issue 24, 1-11

Abstract: International current best practice recommends the discontinuation of antipsychotics for challenging behaviours in people with intellectual disabilities (ID), due to lack of evidence of efficacy and risks of harmful side-effects. In clinical practice, discontinuation may be difficult. The aim of this study was to gain insight into prescribers’ practice by investigating their experiences with the discontinuation of long-term antipsychotics for challenging behaviour. From professionals’ associations thirty-four registered ID physicians, psychiatrists and specialist mental healthcare nurses were recruited who completed an online questionnaire in this survey–study. Almost all participants had attempted to deprescribe antipsychotics for their patients with ID. Sixty-five percent of participants achieved complete discontinuation in 0–25% of their patients, but none in over 50%. Barriers were a lack of non-pharmaceutical treatments for challenging behaviours and caregivers’ and/or family concern. Seventy percent of participants indicated that their institutions had encouraged implementing their discontinuation policies in line with the new Dutch Act on Involuntary care and a new Dutch multidisciplinary guideline on problem behaviour in adults with ID. Support and facilitation of clinicians from institutions’ managers and political and professional bodies may be helpful in further implementation of best practice in the treatment of challenging behaviour in people with ID.

Keywords: intellectual disabilities; antipsychotics; challenging behaviour; discontinuation; prescribers’ policies; survey (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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