Prescribing Psychotropic Medications in Patients with Intellectual Disability: Review and Clinical Pearls

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Individuals with intellectual disability (ID) are the most medicated patient population, whether in institutions or in the community. They are also more vulnerable to side effects of neuroleptic medications, especially in the presence of muscular disorders such as cerebral palsy. Many individuals with ID have multiple medical conditions, which complicate the use of prescription drugs. Mental illness is also more prevalent in this specialized population; psychiatric and behavioral problems occur in ID three to six times the rate relative to the general population (World Psychiatric Assn, 2010). The diagnostic process can be difficult due to communication difficulties, highly variable behavioral presentations, and a lack of universal training for clinicians. Acknowledged experts agree that there is a need for evidence-based medicine, and until this is available, consensus based knowledge will suffice in conjunction with evidence-based principles for the general population. The medication regimens for a patient with ID should look no different than the regimen for any other patient.