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An exploration of staff attitudes to discontinuing use of antipsychotic medication

Anxieties of staff in residential social care need to be addressed when reducing antipsychotic medication, a study shows

Anxieties of staff in residential social care need to be addressed when reducing antipsychotic medication, a study shows


Picture: SPL

Most support staff in residential social care settings believe that antipsychotic medication is effective in controlling behaviours described as challenging, even in the absence of corresponding mental health conditions, a study in the Netherlands shows.

The study, which explored perceptions of staff about discontinuing the use of antipsychotic medications, found that staff attitudes could significantly influence – positively or negatively – the discontinuation process.

Despite limited confidence about successful outcomes, most staff were willing to collaborate on carefully planned discontinuations, the study showed.

Not supported by diagnosis

It used a mixed methods approach that combined focus groups and questionnaires to explore indications for using antipsychotics, reasons for discontinuation, staff expectations and attitudes, and preconditions for discontinuation.

Support staff felt more optimistic about achieving dosage reductions than completely discontinuing medication. They felt successful reductions and discontinuations of medication required close attention to multidisciplinary collaboration and communication as well as proactive planning, including contingency plans to respond to complications, the authors said.

Across the UK there is increasing interest in reducing the overuse of psychotropic medication for people with learning disabilities, particularly where there is no mental health diagnosis to support its use.

For UK learning disability nurses the study highlights the need to recognise, understand and address possible anxieties of direct support staff about reducing antipsychotic medications. If left unaddressed, these anxieties could confound and undermine the success of the medication reduction programmes.


Dave Atkinson is an independent consultant nurse

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