De-Prescribing of Psychotropic Medications in the Adult Population with Intellectual Disabilities: A Commentary

The population with intellectual disabilities is one of the most vulnerable groups in society. Medication use is the main therapeutic intervention in this population and psychotropic medications can be prescribed for mental health conditions and for challenging behaviors. Clinical experience of prescribers and pharmacists working with people with intellectual disabilities suggests that reducing or stopping psychotropic medication is not always straightforward. What is required is rational, rather than rationed, prescribing of psychotropic medications. Concerns of clinicians working with people with intellectual disabilities and both formal and informal carers can result in maintenance of the ‘status quo.’ Setting-related, carer-related and staff-related factors play an important role in the real world of people with intellectual disabilities. Optimizing medication regimens in the adult population with intellectual disabilities is complicated but it is recognized that efforts to improve the current state of medication utilization are required for many individuals with intellectual disabilities. Pharmacists have a responsibility to include the person and/or their carer in their efforts to promote optimization of psychotropic medication use in environment in which the person lives.