As many as 71% of adults with a learning disability were prescribed an antipsychotic when they had no record of any mental illness, a study reported in The BMJ
The report, on 1 September 2015, laid out evidence confirming continuing and frequent inappropriate prescribing of antipsychotics to adults with learning disabilities.
The finding comes just weeks after a report by Public Health England highlighted that one in six adults with learning disabilities, but no diagnosis of mental illness, was being prescribed antipsychotic drugs by a GP.
The BMJ study reveals that only 13% of the 33,016 patients with a learning disability who were prescribed an antipsychotic also had a diagnosis of a severe mental illness. And it found that 47% of patients who had challenging behaviour were treated with antipsychotics, whereas only 12% had a record of severe mental illness.
Adults with a learning disability who had autism or dementia, along with older patients were more likely to be prescribed an antipsychotic than others, according to the study.
“The proportion of people who had been treated with psychotropic drugs was much greater than the recorded rate of psychiatric morbidity,” say the researchers.
They say their findings suggest that “more evidence is needed of the efficacy and safety of psychotropic drugs in this group of patients especially if they have challenging behaviour”.
The study was based on an analysis of 33,016 people with learning disability from 571 UK GP practices.
“Sadly the report’s findings … confirm what we have heard from families time and time again about their loved ones being given high levels of antipsychotic or antidepressant medication, often for years,” says Dan Scorer, head of policy at Mencap, a charity for people with a learning disability.
“In many cases, families report serious side effects and no evidence that the medication is helping the individual. The research shows this is happening not just in inpatient units but in the community as well.”
Viv Cooper, chief executive of the Challenging Behaviour Foundation, says the research highlights a significant risk to vulnerable people. “Fundamental changes must be delivered, addressing a widespread culture of ‘chemical restraint’, and replacing it with individualised positive behaviour support.”
 Sheehan R, Hassiotis A Walters K et al. Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study. The BMJ 2015;351:h4326. doi: 10.1136/bmj.h4326.