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Tijdschrift voor Psychiatrie 61 (2019) 11, 786 - 791

Review article

Practical guidelines for prescribing psychotropic medication to people with intellectual disability

G. de Kuijper, G. Degraeve, J.R. Zinkstok

background In people with intellectual disability (id) prescription of psychotropic drugs is often chronic and outside licensed indications.
aim To provide practical strategies for prescribing psychotropic drugs in people with id.
method We reviewed the literature and existing guidelines to summarize recommendations for prescribing psychotropic drugs in people with id.
results The Diagnostic Manual - Intellectual Disability is a useful tool to facilitate diagnosis of mental disorders in people with id. Challenging behaviour in the absence of a psychiatric disorder is not a licensed indication for prescribing psychotropic drugs. Because of increased vulnerability for side effects in people with id, it is crucial to carry out a risk-benefit analysis before prescribing psychotropic drugs. In line with existing guidelines, we recommend monitoring of treatment and adverse effects with standardized scales adapted for id.
conclusion A careful decision-making process regarding initiation and continuation is essential to prevent insufficient as well as excessive pharmacotherapy in people with id.

keywords challenging behaviour, intellectual disability, mental disorder, psychotropic medication