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Original papers: Tom Marshall Audit of the use of psychotropic medication for challenging behaviour in a community learning disability service Psychiatr Bull 2004; 28: 447-450 [Abstract] [Full text] [PDF]

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Psychotrophic medication in learning disability

Vineet Singh, Preston PR29HT   (30 December 2004)

Psychotrophic medication in learning disability 30 December 2004
Vineet Singh, Specialist Registrar (Adult Psychiatry) Avondale Unit, Royal Preston Hospital, Preston PR29HT Send letter to journal: Re: Psychotrophic medication in learning disability vineet.singh71{at}virgin.net Vineet Singh, et al.	It was interesting to read the audit on psychotrophic medication for challenging behavior in learning disability (Dec 2004). The use of psychotrophic medication in adults with learning disability is fraught with controversy because of the difficulties inherant in making psychiatric diagnosis in this population, where mental illness may present as challenging behavior and where the use of psychotrophic medication for challenging behavior in the absence of mental illness is controversial(Deb & Fraser,1994). In Britain, where the rate of prescription of psychotrophic medication in adults with LD living in the community ranges from 10-19%(Clarke et al 1990). An inpatient study (Wressel et al, 1990) demonstrated a significant reduction in polyphamacy with the introduction of annual mandatory reveiw of all prescriptions. Therefore audits like these might be useful in rationalising prescribing practices as compared to the scenario where litigation in these matters could lead to patients being deprived of medication through fear of legal repercussions. The current ethos should be away from the medical model where drugs are seen as 'magic bullets',towards a more behaviourally oriented approach (Singh et al 1992). Dr Vineet Singh References: DEB,S. & FRASER,W. (1994) The use of psychotrophic medication in people with learning disability: towards rational prescribing.Human Psychopharmacology, 9,259-272. WRESSEL,S.E., TYRER,S.P. & BERNEY,T.P. (1990) Reduction in antipsychotic drug dosage in mentally handicapped patients, British Journal of Psychiatry. 157,101-106. SINGH,N.N., GUERNSEY,T.F. & ELLIS,C.R. (1992) Drug therapy for people with developmental disabilities:legislation and litigation. Clinical Psychology Review. 12, 665-679.