Antipsychotics withdrawal

TitleReducing the amount of antipsychotic medication taken by people with intellectual disabilities: why does it not work?
Purpose To answer the question of why antipsychotic withdrawal in people with intellectual disabilities and those who have challenging behavior often fails.

Target group
Adults with intellectual disabilities who are prescribed antipsychotics (risperidone or pipamperone) for challenging behavior.
Design Double-blind, placebo-controlled, randomized trial.
What does the research involve?Antipsychotics are often prescribed long-term to people with intellectual disabilities and challenging behavior. There is no scientific evidence to prove that antipsychotics help in dealing with challenging behavior. However, adverse side effects, such as diabetes, elevated cholesterol, flattening of emotions, drowsiness, and movement disorders have been convincingly demonstrated. These side effects therefore affect one’s health and quality of life, and they may decrease or disappear after reducing the amount of antipsychotics taken. In practice, withdrawal often fails. It is unclear why withdrawal is frequently unsuccessful.
In this study, we intend to investigate why reducing the antipsychotics medication in people with intellectual disabilities is so difficult.
By dividing the participants (a blind study) into two groups, with one group slowly withdrawing from the drug and the other continuing to use the drug, we hope to answer this question.
DurationThe measurements for this study have been completed. The results are expected to be announced in 2024.
Parties involved Clients from Abrona, Amarant, and Ipse de Bruggen participated in this study. This study could not have taken place without the clients and their legal representatives.
Caregivers, physician assistants, nursing staff, behavioral experts, and physicians assisted in collecting the data for this study.

The researchers who worked on this study are:
– Sylvie Beumer (Intellectual Disability Physician, PhD candidate)
– Mireille Knulst (Healthcare psychologist, PhD candidate)
– Marie-Louise Hoekstra-van Duijn (Intellectual Disability Physician in training, PhD candidate)
– Pauline Hamers (Special needs teacher, PhD candidate, co-supervisor)
– Dederieke Maes-Festen (Intellectual Disability Physician, postdoc, co-supervisor)
 
The antipsychotics study (Project no. 848016008) is part of the
ZonMw Goed Gebruik Geneesmiddelen (GGG) program (Good Use of Medication translated into English from Dutch).
ImplementationWe hope that the results will help us explain why withdrawal often fails. This could reduce the inappropriate use of antipsychotics in intellectually disabled care. The results are expected in 2024.
Would you like to learn more?Send an email to goud.antipsychotica@erasmusmc.nl or call 010 70 33 847.