Discontinuation of antipsychotic medication improves behavioral functioning and metabolic outcomes

By Gerda de Kuijper, MD
Centre for Intellectual Disabilities and Mental Health, Assen, The Netherlands
University of Groningen

Individuals with intellectual disability (ID) frequently use antipsychotic medications for challenging behavior although there is no evidence for their effectiveness. In fact, antipsychotic medications may cause harmful side effects like weight gain, glucose impairment, and potential irreversible neurological side effects such as abnormal, involuntary movements. Therefore discontinuation should be considered.

What did you do in your research?
We tapered off (gradual withdrawal) antipsychotic medications in 98 individuals with ID who used them for more than one year, for behavioral symptoms. Participants were from three organizations in the Netherlands. Tapering occurred in one of two time frames: at 14 or 28 weeks.

What did you find out?
Complete antipsychotic medication discontinuation succeeded in almost half of participants and led to improvement in behavioral functioning. Medication discontinuation also led to favorable metabolic outcomes. Results of both discontinuation schedules (14 weeks and 28 weeks) were similar.

What are the take-home messages?
Clinicians who prescribe long-term antipsychotics for treatment of challenging behaviors of their patients with ID should be encouraged to try to taper off these agents. Discontinuation does not lead to worsening in behavior and has favorable metabolic outcomes. There is no need to taper off in a time frame longer than 14 weeks.

To learn more about these findings contact
Gerda de Kuijper.

Full Journal Article
de Kuijper, G., Evenhuis, H., Minderaa, R. B., & Hoekstra, P. J. (2014). Effects of controlled discontinuation of long-term used antipsychotics for behavioural symptoms in individuals with intellectual disability. Journal of Intellectual Disability Research, 58, 71–83.