CDC: 6% of Teens take Psychotopic Medications Versus 58% in Developmental Disabilities

PBS may substitute for
Psychoactive medications overuse

It has always been a known fact that overuse of psychotropic medications have become a problem in our society.  This is more so in the population with developmental disabilities.  A reasonable percentage of I/DD population have limited language skills and are not capable to communicate needs and wants effectively. Therefore, they utilize disruptive and challenging behaviors to communicate needs.  Most of these challenging behaviors are learned and reinforced inadvertently by caregivers and support staff. Understanding and sensitivity to verbal and non verbal behaviors and timely response to needs are the key to effective support. Use of psychotropic medications to manage challenging behaviors without diagnostic justification has resulted in the overuse of these medications.  These basic evidence-based guidelines will assist in the prevention of overmedication and the attendant side effects and complications. Psychotropic medication is not the only avenue if an adolescent is challenged by mood disorders or ADHD.  There could be psychotherapeutic intervention or positive behavioral support (PBS).
Challenging behaviors are means to communicate needs and wants.  It is important for caregivers and professional support staff to understand the non-verbal communication when it occurs.  Challenging behaviors are used to communicate needs and in many instances are symptoms of underlying medical and psychosocial needs.  Psychotropic medications are frequently used to treat undesirable behaviors in persons with developmental disabilities. Successful use of these drugs is dependent on accurate assessment of the psychiatric disorder or behavioral problem.
Working with children who have developmental disorders is challenging. Besides having physical deficits, or intellectual deficits, or both, these children are at high risk for developing psychiatric disorders.  

Psychoactive med overuse
 is Chemical Restraints

"Everyone who is depressed doesn't have to take medication and everyone who has ADD doesn't have to take medication," said Dr. Ken Duckworth, medical director of the National Alliance on Mental Illness.
Justification for use of psychoactive medications must be based on a diagnosis of a  psychiatric disorder. Symptomatic treatment often result in overmedication and misuse.
Overuse and misuse of psychotropic medications are considered Chemical Restraint and Bad Practice. The cost to Medicaid is prohibitive. Health care costs for the 4.9% of

the Medicaid population with ID account for 15.7% of total

 Medicaid expenditures.

Usual Side-effects/Complications of Psychotropic  Medications include but not limited to:

• Drowsiness
• Dizziness when changing positions
• Blurred vision
• Rapid heartbeat
• Sensitivity to the sun
• Skin rashes
• Menstrual problems for women.
• Rigidity
• Persistent muscle spasms
• Tremors
• Restlessness.

At Heritage Behavioral Services, we want to remind caregivers and support staff that any side effect of the psychotropic medication could present as challenging behaviors in someone with limited language skills.