Study questions why thousands with developmental disabilities are prescribed antipsychotics

Thousands of people with Down syndrome, autism and other developmental disabilities are being prescribed anti-psychotic medication by Ontario doctors despite a lack of evidence that the drugs actually help them, a new study has found.

Researchers with the Centre for Addiction and Mental Health and the Institute for Clinical Evaluative Sciences have called for “guidelines and training around antipsychotic prescribing and monitoring” for doctors, pharmacists and care home staff after finding that nearly 40 per cent of people with developmental disabilities were prescribed antipsychotic drugs at some point over a six-year period.

One-third of the patients prescribed antipsychotics had no documented diagnosis of mental illness, according to the study which tracked over 51,000 people with developmental disabilities who are eligible for provincial drug benefits.

“We don’t know, with the data, why this one person was prescribed or this (other) person was prescribed so we’re trying to almost guess at why,” psychologist and lead author of the study Yona Lunsky said.

“It could be behaviour, aggression, self-injury, agitation.”

For people with developmental disabilities who live in group homes, the rate of antipsychotic prescriptions was even higher.

About 56 per cent of developmentally disabled group home residents were prescribed antipsychotics. Of those, around 43 per cent had no documented mental health issues.

There is “inconclusive” evidence that antipsychotics are effective in treating the behaviour of developmentally disabled patients who do not have a mental illness, Lunsky said.

While some studies show antipsychotics can be effective in individual cases, over a short period of time, there is no reliable evidence on long-term use of antipsychotics by people with developmental disabilities, Lunsky said. And it is unlikely that all antipsychotic users found in the study need to be taking them, she added.

“There’s no way every single one of those people is on that drug for the right reasons and being very carefully monitored.”

It’s overly simplistic, though, to assume doctors are just prescribing antipsychotics as a “quick fix” for challenging behaviour, Lunsky said.

Psychologist Yona Lunsky is lead author of a study showing that thousands of Ontarians with developmental disabilities are being prescribed antipsychotic medications.

One of the major factors behind the number of prescriptions could be the fact that medications are…

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