Too Many Meds: Medications Are Overprescribed To Those With Disabilities

Many of us have had uncomfortable moments when a person with autism “acts out” or does something inappropriate. Sometimes these behaviours can be aggressive and downright scary for a parent or caregiver.  While it might be easier to imagine that prescribing a drug could minimize these events or make them stop altogether, new research out of the UK suggests that many people with intellectual disabilities are overprescribed medications in an effort to treat problem behaviours such as aggression and self-injury, despite there being little evidence of any benefit from these medications. 

The problem? The study found that 71 percent of those with intellectual disabilities who were prescribed antipsychotics had no record of severe mental illness, which is what the drugs are designed to treat. While sometimes the behavioural outcomes might seem similar, effective treatments for mental illness versus intellectual disabilities are quite different. 

In a previous abstract on the topic , the “challenging behaviours” that were being treated with antipsychotic medications covered a very broad range including behaviour that caused harm to people or property, and difficult to manage behaviours that were seen as causing limited access to community facilities. The abstract found that “antipsychotic medications have been used to modify such behaviours in people with learning disabilities, but there is little evidence to suggest that the benefits outweigh the risks.”

Risks and side effects for these medications can include blurred vision, weight gain, moderate to extreme drowsiness, dry mouth, muscle spasms and tremors, and dizziness.

“Research evidence does not support using antipsychotics to manage behaviour problems in people with intellectual disabilities,” said Rory Sheehan of University College London, who led the study. “Many people with intellectual disability and behaviour disturbance have complex needs, and other interventions, such as looking at the support people receive and their communication needs, should be prioritized. Antipsychotics, or indeed any medications, should not be prescribed lightly and are no substitute for comprehensive care.”

Aggressive, self harming or inappropriate behaviour can be tough for any parent or care giver to deal with. One of the best methods I have found has been the Studio III Low Arousal Approach. This time-tested system offers a non-aversive way to help your child, student, or ward through difficult moments by offering practical guidelines and tools for understanding the causes of challenging behaviour through the use of  “low-arousal” approaches which include interaction, defusion and distraction strategies.

Two other resources that I have personally found to be very helpful are A Practical Guide to Mental Health Problems in Children with Autistic Spectrum Disorder – It’s not just their autism! and Hope for the Violently Aggressive Child: New Diagnoses and Treatments that Work .

Remember: if you are having difficulty dealing with a child or adult who has challenging behaviour,  you are not alone and help is available. Our newly updated autism resources page has listings of relevant help, services, and resources offered in Canada, the US, the UK, and around the world.