Clozapine use in women with borderline personality disorder and mild learning disability reduced rates of self injury and use of restraint

Medication

Clozapine is an atypical antipsychotic medication used to treat the symptoms of schizophrenia, most usually used as a treatment of last resort where people have not responded to other anti-psychotic treatments.

It has a number of severe side effects including and can also cause the excessive production of saliva and weight gain..

The researchers in this study were interested in whether Clozapine reduces rates of self injury and consequently the use of restraint. They were looking at this in the context of a medium secure setting and looking in particular at female patients with a diagnosis of borderline personality disorder and mild learning disability. They had found no previous studies of the use of this medication for this purpose with this group.

They collected data retrospectively for women who had been taking clozapine for a six month period, collecting information on rates of self injury and the use of restraint.

What they found was that in the six months prior to Clozapine the mean number of incidents of self injury was 20.75 (SD 8.8) and in the six months following Clozapine, it was 13.5 (SD 4.51) a reduction of 35 %.

In relation to the use of restraint, in the six months prior to Clozapine this was 17.75 (SD 6.86) and in the six months following Clozapine, it was 9.25 (SD 4.96), a reduction of 48%.

They found from statistical analysis that the difference between the means of both self injury and use of restraint was not statistically significant.

The authors conclude that their findings suggest a clinically significant reduction in rates of self injury and use of restraint in women with a diagnosis of borderline personality disorder and mild learning disability as a result of treatment with Clozapine.

Clozapine use in women with borderline personality disorder and co-morbid learning disability, Fajumi T et al., in Journal of Learning Disabilities and Offending Behaviour, 3, 1,.6 – 11

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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