Voorschrijven van psychofarmaca bij mensen met een verstandelijke beperking: Handvatten voor de praktijk

Abstract

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.