Psychotropic medications ‘over-prescribed’

People with cognitive disability are being over-prescribed psychotropic medication, according to a report from The Royal Commission.

And, despite the absence of reliable statistical data, there is ample evidence to suggest that these medications for so-called ‘behaviours of concern’, are in too many cases, also being used as a form of chemical restraint.

The report accepts that while widely used and commonly understood, the use of the phrase ‘behaviours of concern’ is controversial, acknowledging that such behaviours, particularly for people with cognitive disability are a form of communication.

A large body of medical evidence, along with anecdotal observations from family and carers, identified to the commission that people with cognitive disability often experience serious negative consequences as a result of using such medication.

These side effects may include reduced cognitive functioning, nausea, headaches and weight gain and be further exacerbated over the longer term if the psychotropic medication interacts adversely with other drugs.

The report outlines that there is limited evidence to support the efficacy of psychotropic medication as a way to address behaviour escalation. In some instances, while it may act as a sedative for many people with cognitive disability, it has the opposite effect and can lead them to express increasing and varied behaviours of concern.

As an alternative to psychotropic medication the practice of ‘positive behaviour support’ (PBS) can significantly reduce the incidence of behaviours of concern and reduce the need for the use of psychotropic medications as chemical restraints.

There are calls for much better training for medical professionals regarding the use and prescribing of psychotropic medications and a need for better education about the underlying causes of escalating behaviours, and improvements in PBS planning, rather than a focus on the behaviours and blaming the person being treated.

Better communication is also vital to ensure that, whenever possible, informed consent to use psychotropic medication is sought and given, and alternative methods of behaviour management are suggested and discussed.

You can read the full report on the DRC website.