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Stopping, rationalising or optimising antipsychotic drug treatment in people with intellectual disability and/or autism

Shankar, R; Wilcock, M; Oak, K; McGowan, P; Sheehan, R; (2019) Stopping, rationalising or optimising antipsychotic drug treatment in people with intellectual disability and/or autism. [Review]. Drug and Therapeutics Bulletin , 57 (1) pp. 10-13. 10.1136/dtb.2018.000009. Green open access

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Abstract

Intellectual disability (ID; also known as learning disability) is characterised by significant impairment of both cognitive functioning and adaptive behaviours, and an onset in early childhood. People with ID experience a different pattern of morbidity to the general population and die considerably younger than their counterparts without ID. Autism is a neurodevelopmental disorder characterised by troubles with social interaction and communication, and by restricted and repetitive behaviour. In both conditions, complex mental and physical health problems, as well as social issues, are common and are associated with communication difficulties that can result in maladaptive behavioural patterns (often referred to as ‘behaviour that challenges’). Ideally, all people presenting with behaviour that challenges should be assessed by a specialist multidisciplinary team (comprising psychiatrists, psychologists, speech and language therapists, occupational therapists) to develop an understanding of the behaviour and an appropriate support plan with tailored treatment strategies and specialist follow-up. Non-pharmacological interventions for challenging behaviour, such as positive behavioural support or cognitive–behavioural therapy and manipulation of environmental triggers, are preferred to psychotropic medication. However, antipsychotic medication is often prescribed to adults with ID and/or autism to manage behaviour that challenges in the absence of severe mental illness, despite there being little research evidence that antipsychotics are effective in this context.

Type: Article
Title: Stopping, rationalising or optimising antipsychotic drug treatment in people with intellectual disability and/or autism
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/dtb.2018.000009
Publisher version: https://doi.org/10.1136/dtb.2018.000009
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10065132
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