Psychopharmacology

Deb, Shoumitro

doi:10.1007/978-3-319-26583-4_13

Cited by 22 publications

(8 citation statements)

References 151 publications

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“…It is known that psychotropic medication is commonly used amongst people with intellectual disabilities and aggressive behaviour (Deb et al . ; Deb ) and the present results support this. However, the sample is not representative of the wider population with intellectual disabilities as participants were recruited via psychiatrist‐led clinics and it would be anticipated that people would be in touch with psychiatrist for medication‐based intervention.…”

Section: Discussionsupporting

confidence: 90%

“…However, costs for senior trainees, who would often see patients with intellectual disabilities and aggressive behaviour, are comparable to those of a junior consultant because of on‐call supplements. In the UK, psychiatrists are primarily involved in the management of aggressive behaviour by assessing and treating underlying mental health problems but sometimes managing aggressive behaviour with medication in the absence of a diagnosable psychiatric disorder (Deb , ; Hemmings et al . 2013).…”

Section: Discussionmentioning

confidence: 99%

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An Exploration of Costs of Community‐Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities

Unwin

Deb

Deb³

2016

Research Intellect Disabil

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It seems that in terms of costs, there is an overreliance on medication and psychiatrists and a relatively lesser reliance on other CLDT members such as community nurses and clinical psychologists for the management of aggressive behaviour in adults with intellectual disabilities within community settings. Health commissioners may wish to explore this relative cost discrepancy further and try to redress the balance where appropriate.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

An Exploration of Costs of Community‐Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities

Unwin

Deb

Deb³

2016

Research Intellect Disabil

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“…A recent meta-analysis (Bruinsma 2020) found a significant moderate overall long-lasting effect of non-pharmacological interventions on behaviours that challenge (d = 0.573). In contrast, the evidence for the effectiveness of medication in improving such behaviour is at best equivocal (Deb 2016b).…”

Section: Current Treatment Practicesmentioning

confidence: 99%

Pharmacological management of psychopathology in people with intellectual disabilities and/or autism spectrum disorder

Roy

Limbu

2022

BJPsych advances

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SUMMARY On average, 49–63% of people with intellectual disabilities and/or autism spectrum disorder (ASD) are prescribed psychotropic medications to treat psychopathology, including psychiatric illness, behaviours that challenge and the core symptoms and associated behaviours of these developmental disorders. In many cases, psychotropics, particularly antipsychotics, are used off-label without a proper indication, particularly to manage behaviours that challenge. The RCTs show moderate evidence supporting the efficacy of low-dose risperidone and some preliminary evidence for aripiprazole in treating behaviours that challenge among children with ASD and/or intellectual disabilities. The RCT-based evidence for the other psychotropics is equivocal, so no definitive conclusions can be made on their efficacy. Polypharmacy and the use of high doses of antipsychotics are prevalent in this population, leading to the risk of adverse events and drug–drug interactions. Despite various national and international guidelines, and government initiatives encouraging reduced psychotropic use, there is little evidence of this happening; on the contrary, the use of antidepressants, mood stabilisers and benzodiazepines may be increasing. A concerted multi-agency effort is urgently needed to address this significant public health concern of the overmedication of people with intellectual disabilities and/or ASD.

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“…2020). Yet, despite the poor evidence for the effectiveness of psychotropic medications in managing behaviours of concern (Deb 2016), psychotropic medications are used widely among adults with IDs (49–63%) and are often prescribed in the absence of a psychiatric diagnosis (Sheehan et al . 2015).…”

Section: Introductionmentioning

confidence: 99%

Training support workers about the overmedication of people with intellectual disabilities: an Australian pre–post pilot study

Wilson

Barratt

Jorgensen

et al. 2023

J intellect Disabil Res

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Background There is evidence that psychotropic medications are overprescribed and overused to manage behaviours of concern for people with intellectual disabilities. Disability support workers and support staff lack education and training on the administration and safety of psychotropic medication use. This study aimed to test the applicability and preliminary efficacy of SPECTROM, an education programme developed in the UK, in an Australian context. MethodsThe training comprises two parts: Module 1 encompasses psychotropic medications, their use and side effects. Module 2 focuses on non-pharmacological interventions for supporting people with behaviours of concern. Thirty-three participants attended the training course and completed pre-training and post-training surveys on the Psychotropic Knowledge Questionnaire and Management of Aggression and Violence Attitude Scale-Revised at four time points: pre-training, 2 weeks, 3 months and 5 months post-training. Results Psychotropic Knowledge Questionnaire scores showed statistically significant post-training improvement at all post-training time points (P < 0.05). Management of Aggression and Violence Attitude Scale-Revised scores were high at pre-training and did not change significantly at any of the post-training survey time points. A 2-week posttraining feedback questionnaire reported 80% agreement that the training programme was appropriate, useful and valid. Only 36% of participants completed questionnaires at all time points. Conclusions SPECTROM training increased staff knowledge of psychotropic medications, yet loss of participants was high. Further refinement of the applicability of the training for the Australian context and evaluation of the feasibility of implementation, clinical and cost-effectiveness of the programme are required.

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Psychopharmacology

Cited by 22 publications

References 151 publications

An Exploration of Costs of Community‐Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities

An Exploration of Costs of Community‐Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities

Pharmacological management of psychopathology in people with intellectual disabilities and/or autism spectrum disorder

Training support workers about the overmedication of people with intellectual disabilities: an Australian pre–post pilot study

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