Antilibidinals – Cure or Curse? Long-Term use of Antilibidinal Medication in Adult Patients with Learning Disability

Abstract

Abstract The initiation of antilibidinal medication is clearly an area in which clinicians need to become skilled when managing patients with learning disability. Clinicians need to be aware of contra-indications and side effects and have a clear indication for the use and continuation of medication. Every effort should be made to enhance capacity of patients to consent for this complex treatment following the framework set out in the Mental Capacity Act (2005). Behavioural and psychological treatment must always be considered first line therapy in patients with learning disability presenting with sexually inappropriate behaviour. There is a potential for abuse of pharmacological therapy, especially in people with learning disability. It may be used to suppress normal sexuality based on the misperception that it is wrong for people with learning disability to express their sexuality. It may be an easier option where there are a lack of resources such as access to psychological therapies. This brings to light ethical issues surrounding the use of this questionable treatment as a substitute for psychological and behavioural therapies. In order to avoid this potential misuse, there is a need for guidelines, clinician training and a protocol based on good practice guidelines ensuring that clinical practice is standardised. Using protocols will also ensure that psychological and behaviour therapies are considered prior to pharmacological therapy and side effects are monitored for and recorded.