Characteristics That Discriminate Between Successful and Unsuccessful Drug Withdrawal Candidates Among Mentally Retarded Persons (Neuroleptic, Psychotropic, Major Tranquilizers)
Research has recently demonstrated that the decision to treat learning and behavior problems of mentally retarded persons with neurolepic drugs is questionable. Many mentally retarded persons receiving neuroleptics should not remain on these drugs because the drugs have not suppressed maladaptive behaviors and have in some cases, interfered with learning. Unfortunately, little empirical data, or even clinical information, exists regarding subject characteristics that may discriminate between successful and unsuccessful drug withdrawal candidates among mentally retarded persons. The purpose of this dissertation was to examine whether the judgement to maintain mentally retarded persons on neuroleptic drugs was associated with demographic, drug, reason-on-drug, or clinical-note variables. The 125 mentally retarded persons in this study, residing in an institution and primarily severely handicapped, formed four groups: (a) a "drug withdrawal group," consisting of individuals whose medication was totally withdrawn; (b) a "drug reinstatement group," consisting of individuals whose medication was reduced and subsequently reinstated; (c) a "drug control group," consisting of individuals who had been on medication continually; and (d) a "no-drug control group," consisting of individuals who had not received medication during the five years prior to this study. Data were collected from individual subject files across three or four time periods: (a) during baseline, (b) before total drug withdrawal or reinstatement, (c) after drug withdrawal or reinstatement, and, in some instances, (d) during a follow-up period. The results from this study analyzed via multivariate statistics, indicated that mentally retarded persons were more likely to remain on neuroleptics if they were prescribed a high drug dose and were perceived by direct-care staff as causing disturbances, displaying self-stimulation, and/or exhibiting physical aggression. None of the demographic variables, number of months on drug, presence of tardive dyskinesia, or more importantly, the behavioral reasons for initial prescription of drugs were found to be reliable predictors of remaining on neuroleptic medication. The implications of this investigation for clinical-drug monitoring systems are discussed.
University of Illinois - Urbana-Champaign
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University of Illinois at Urbana-Champaign