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Antipsychotic medication for challenging behaviour in people with learning disability

The term 'challenging behaviour', in the absence of psychiatric disorder, encompasses a wide range of behaviours that may be harmful to people or property, may be difficult to manage and may limit access to community facilities. Antipsychotic medications have been used to modify such behaviours in people with learning disability, but there is no randomised controlled trial-based information that suggests antipsychotic medication is either helpful or harmful for adults with learning disability and challenging behaviour.

Uvod

The term 'challenging behaviour', in the absence of psychiatric disorder, encompasses a wide range of behaviours that may be harmful to people or property, may be difficult to manage and may limit access to community facilities. Antipsychotic medications have been used to modify such behaviours in people with learning disability, but there is little evidence to suggest that the benefits outweigh the risks.

Ciljevi

To determine the effectiveness of antipsychotic medication for people with learning disability and challenging behaviour without additional mental illness.

Metode pretraživanja

Biological Abstracts, the Cochrane Library, EMBASE, MEDLINE, PsycINFO and BIOSIS were searched. Further references were sought from published trials and pharmaceutical companies. Trials were reliably identified and data extracted.

Kriteriji odabira

All randomised controlled trials of antipsychotic medication versus placebo.

Prikupljanje podataka i obrada

Reviewers independently evaluated and analysed data on an intention to treat basis. Data were evaluated at 4, 8 and 12 weeks as longer follow-up data were not available. Reviewers assumed that those subjects lost to follow-up had a bad outcome.

Glavni rezultati

Only nine randomised controlled trials could be included in the analyses. These provided no evidence of whether antipsychotic medication helps or harms adults with learning disability and challenging behaviour.

Zaključak autora

There are limited data on this important issue and more research is urgently needed.

Citat
Brylewski J, Duggan L. Antipsychotic medication for challenging behaviour in people with learning disability. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD000377. DOI: 10.1002/14651858.CD000377.pub2.

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