‘Little evidence’ anti-psychotics help treatment of challenging behaviour

POWERFUL anti-psychotic drugs continue to be the dominant model of intervention in the treatment of adults with intellectual disability, though there is little research evidence to support the practice, an expert in the area has warned.

Dr Ian Grey, who was involved in carrying out some of the only research on the topic in Ireland, said there is little research evidence to support the use of such medication in the treatment of challenging behaviour and that evidence is “inconclusive at best”.

While multi-disciplinary teams are frequently proposed for the treatment of challenging behaviours, few teams operate with a joined-up coherent strategy.

“The reality in the majority of cases is a team of specialists with competing models of intervention characterised by independent working and poor cross communication,” he said.

“It is not unusual for someone with challenging behaviour to meet with a psychiatrist one day and a psychologist or another team member a few days later. Either may make changes but collective agreed changes are uncommon.”

Medication changes, if they do occur, most often happen based upon anecdotal reports of how the person has been in the previous week by staff rather than a coherent overall picture using objective information.”

Dr Grey was backing revelations in the Irish Examiner by Dr Brian McClean, a psychologist with the Brothers of Charity, who said people with an intellectual disability who display challenging behaviour are being “subdued” with medication that is used to pacify them in the absence of other interventions.

Dr Grey also said a British study in 2009 had demonstrated that people with intellectual disabilities who showed aggressive challenging behaviours had shown greater improvement when receiving a placebo.

Darach Murphy, whose brother Seamus lives in an intellectual disability service, said he is unhappy with the medication his brother is given. Among other drugs, Seamus is prescribed an anti-psychotic, Risperdal, generally used to treat schizophrenia and symptoms of bipolar disorder.


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