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2 September 2015

Anti-psychotic drugs and epilepsy

Epilepsy Society has stressed that anti-psychotic drugs should only ever be prescribed for people with epilepsy where essential. The charity's medical director Professor Ley Sander said this was particularly important when prescribing for those who also had learning difficulties.

The warning follows a report from University College London (UCL) which shows that thousands of people with learning disabilities are being prescribed anti-psychotic drugs, even though there is little evidence that they work. The drugs are being used to tackle challenging behaviour in those who do not have a record of severe mental illness.

The report also highlights the fact that anxiety drugs and anti-depressants are being prescribed in large numbers.

UCL study results

Experts at UCL which works closely with Epilepsy Society, analysed the data of 33,000 people with learning disabilities including people with Down's syndrome, autism and epilepsy.

The study, published in the British Medical Journal, found that 9,135 people had been prescribed anti-psychotic drugs although 71 per cent of them had no record of severe mental illness. Of the 11,915 people with a record of challenging behaviour, 47 per cent had received anti-psychotic drugs whereas only 13 per cent had a record of severe mental illness.

Twenty-six per cent of those given anti-psychotic drugs did not have a record of severe mental illness or challenging behaviour.

Risk of psychosis in epilepsy

Epilepsy Society's Professor Ley Sander said: 'Between 20-30 per cent of people with epilepsy may also experience some mental health problems, the most common being anxiety and low mood.

'The risk of psychosis among people with epilepsy is 6-12 times greater than in the general population with a prevalence of up to 7-8 per cent. In people with drug-resistant temporal lobe epilepsy, it can be even higher.

'Anti-psychotic drugs should only ever be prescribed for people with epilepsy -particularly those who also have a learning disability - if it is essential. Some anti-psychotic drugs can lower the seizure threshold and therefore it has to be a delicate balancing act of treating the psychosis and not leaving the person vulnerable to more seizures.'