Doctors are being warned not to routinely give people with
learning disabilities anti-psychotic drugs to curb aggressive behavior.
An Imperial College London study of 86 patients found the
drugs were no more effective than being given none at all.
Researchers said it was more important to address the
underlying causes.
In the UK, 200,000 people with learning disabilities are given
anti-psychotic drugs - even though there is a risk of side-effects, the Lancet
reported.
These can include risk of weight gain, impotence and strain
to the cardiovascular system.
The team studied patients in 10 inpatient and community
settings in England, Wales and Australia.
One group was given haloperidol, a first-generation
antipsychotic drug, a second group got risperidone, a second-generation
version, while a third received a dummy pill.
Clinical assessments of aggression, aberrant behavior,
quality of life, adverse drug effects and feelings towards their career were
recorded at four, 12 and 26 weeks.
The researchers found that aggression had decreased
substantially with all three treatments by week four, but patients receiving
the dummy pill had the greatest change.
Improvements were seen with the other measures, but these
were similar for all three groups.
Lead researcher Professor Peter Tyrer said: "The
problem with patients with learning disabilities is that we haven't had the
evidence on whether anti-psychotic drugs work.
"Therefore, these patients were assumed to be the same
as other mental health patients.
"But what our research shows is that drugs are no
better than not giving any drugs. It seems what is important is the care a
person receives.
"When people with learning disabilities are aggressive
it is important they are given support and people communicate with them."
But he added that there would still be exceptional
circumstances where such drugs were necessary.
Dr Jim Kennedy, prescribing spokesman at the Royal College
of GPs, agreed.
But he added: "All too often the drugs are used as a
chemical restraint. This can be poor practice."
And David Congdon, from the Mencap charity, said:
"Anti-psychotic drugs should be seen as a last resort.
"Challenging behavior is caused by many different
factors - an undiagnosed health condition causing extreme pain, frustration at
not being able to communicate properly, or boredom due to a lack of meaningful
activity.
"All of this can be dealt with without the use of
anti-psychotic drugs."