Psychotropic drugs are being prescribed to people with intellectual disability for reasons other than mental illness, researchers report today.
Instead they are frequently used to tackle challenging behaviour, according to a study of GP records.
People with intellectual disability develop mental illness at rates similar to or higher than the general population, explain Dr Rory Sheehan of University College London, UK, and colleagues in The BMJ.
But they add, "Atypical presentations, deficits in communication and health literacy, and difficulties in accessing services might mean that mental illness in people with intellectual disability is under-recorded."
Furthermore, "a significant proportion of people with intellectual disability display challenging behaviour."
Because concern are often raised that psychotropic drugs are overused in people with intellectual disability, the team set out to discover the true rates of mental illness, challenging behaviour and psychotropic drug prescriptions in people with intellectual disability.
The study used figures from 571 general practices, covering 33,016 men and women with intellectual disability.
Analysis showed that 21% had a record of mental illness, 25% had a record of challenging behaviour, and 49% had a record of prescription of psychotropic drugs.
Psychotropic drugs prescriptions "far exceeds the proportion with recorded mental illness," say the authors. "Antipsychotics are often prescribed to people without recorded severe mental illness but who have a record of challenging behaviour".
Dr Sheehan said yesterday: "Over 70% of people with intellectual disability who have been prescribed antipsychotic medication do not have a record of severe mental illness. Challenging behaviour, autism, dementia, and older age, were all independently associated with prescription of antipsychotics.
"This highlights a need for strategies to improve psychotropic prescribing to people with intellectual disability. Alternative management options, including behavioural and communication support, should also be further evaluated and interventions that work should be readily available."
Sheehan, R. et al. Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study. BMJ 2 September 2015 doi: 10.1136/bmj.h4326 [abstract]
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