Factors associated with the successful or unsuccessful withdrawal of antipsychotic drug therapy prescribed for people with learning disabilities.
Adults with ID on low-dose thioridazine, epilepsy, and no severe behavior have the cleanest shot at antipsychotic withdrawal.
01Research in Context
What this study did
Doctors looked at 123 adults with learning disabilities who were taking antipsychotic drugs. They tried to stop the drugs and watched who stayed off them for at least six months.
The team wrote down each person's dose, drug name, and behavior. They also noted who had epilepsy or other health issues.
What they found
Only 31 people stayed off the drugs. Success was more likely if the person took a low dose of thioridazine, had epilepsy, and showed no severe aggression or hyperactivity.
High doses, other drug types, and serious behavior problems predicted failure.
How this fits with other research
Webb et al. (1999) later searched for trials and found no proof that antipsychotics help challenging behavior in the first place. Their review includes the 1996 data and shows why stopping may be worth trying.
Burack et al. (2004) counted 873 Australians with ID still on these drugs years later. Their survey extends the 1996 finding by showing how rarely withdrawal is attempted.
Cohen-Almeida et al. (2000) compared side effects and found newer atypical drugs caused fewer problems than older ones. This supports tapering older drugs first, matching the 1996 success with thioridazine.
Why it matters
If you serve adults with ID, screen for low-dose thioridazine, epilepsy, and calm behavior. These clients are your best candidates for a slow drug taper. Pair the trial with behavior data and medical backup. Reducing unnecessary antipsychotics cuts side effects and may not increase problem behavior.
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02At a glance
03Original abstract
Many published accounts of drug review programmes have reported reductions in the prescribing of psychotropic drugs prescribed for people with learning disabilities. Rarely though has the outcome for the patient been reported. The Leicestershire antipsychotic drug review programme resulted in antipsychotic drug dose reduction or withdrawal in 123 patients. Data relating to outcomes were analysed in order to identify factors associated with successful withdrawal. Few such factors were identified. The successful withdrawal of antipsychotic drug treatment (31 patients) was associated with low doses, predominantly of the drug thioridazine, minimal psychopathology, the presence of epilepsy, and the lack of hyperactivity, aggression of stereotypy.
Journal of intellectual disability research : JIDR, 1996 · doi:n/a