Psychotropic medications for adults with intellectual disabilities
Author(s)
Deb, Shoumitro
Type
Chapter
Abstract
Around 50% of adults with intellectual (learning) disabilities who live in community accommodations are prescribed psychotropic (mental health) medications such as antipsychotics, antidepressants, antianxiety, mood stabilisers, including antiepileptics, sedatives and hypnotics. Although these medications are licensed primarily for treating mental illness, they are often prescribed to manage behaviours of concern in the absence of a mental illness in this population. The RCT-based evidence supporting their use in managing behaviours of concern is weak, but the evidence of harm is strong. Therefore, clinicians will have to carefully weigh benefits against harms for each intervention, taking into consideration the views of the person with intellectual disabilities and, where appropriate, their families, after a full multidisciplinary discussion. Any intervention must be in the person's best interest, help improve the person’s quality of life, and cause minimal harm. Recent studies have shown that with a concerted multidisciplinary effort, dose reduction and discontinuation of antipsychotic medications are possible even after many years of use. However, a thorough preparation involving all stakeholders is paramount as there is always a potential risk of behaviour deterioration upon dose reduction and psychotropic medication withdrawal. Where available, the clinician should follow national and international guidelines. However, to assess the appropriateness of the prescription or any other intervention, the clinician should ask the following questions: (a) Is the intervention in the best interests of the person and is likely to improve their quality of life?, (b) Does it conform the country’s law?, (c) Is there an evidence-based rational for their use, which has that been recorded in the file?, (d) Does the intervention provide the best balance between benefit and harm? (e) Has the intervention been agreed with the person with intellectual disabilities and, where appropriate, their families? (f) Has the intervention been discussed fully with the multidisciplinary team involved in the person's care? (g) Have all assessments using a biopsychosocial schema and investigations been completed, and an interdisciplinary formulation and treatment plan agreed? (h) Have monitoring arrangements for the positive and negative impacts of the intervention been put in place, including their time scale?
Editor(s)
Yiu-wa, SO
Shek-ming, Leung
Ng, Fanny
Date Issued
2026-08-07
Citation
Positive Use of Medication: A Reference for Psychotropic and Related Medication Use in People with Intellectual Disability, 2026, pp.6-15
ISBN
9789628230419
9628230417
Publisher
The Mental Health Association of Hong Kong
Start Page
6
End Page
15
Journal / Book Title
Positive Use of Medication: A Reference for Psychotropic and Related Medication Use in People with Intellectual Disability
Copyright Statement
© 2026 The Mental Health Association of Hong Kong.
Subjects
People with mental disabilities
Place of Publication
Hong Kong
Publication Status
Published
Date Publish Online
2026-08-07