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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.

Latar Belakang

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.

Matlamat

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

Kaedah Pencarian

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.

Kriteria Pemilihan

All randomised controlled trials of antipsychotic medication versus placebo.

Pengumpulan Data dan Analisis

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.

Keputusan Utama

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.

Kesimpulan Pengarang

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

Petikan
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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