'As required' neuroleptics: Have these drugs a place in the management of challenging behaviour in intellectual disability?

The present study examined the prescription pattern and usage of 'as requir ed' neuroleptics (PRNs) in the management of challenging behaviours in peop le with intellectual disability in a hospital setting. The prescription car ds and drug administration records of residents were scrutinized to see how many of them were prescribed PRNs and how many had actually received these drugs during the previous 3 months. The results were compared in the follo wing groups: (I) males and females; (2) the behavioural and non-behavioural sectors; (3) intensive treatment wards (ITWs) for severe challenging behav iour which had a better staff:resident ratio than the rest of the behaviour al wards; and (4) those prescribed PRNs together with the daily administrat ion of neuroleptics and those without. It was found that more females used PRNs and that the prescription rate was higher in the behavioural sector. A better staff:resident ratio did not bring about any reduction in the usage of PRNs. The use of these drugs was not influenced by whether PRNs were pr escribed along with regular neuroleptics or not. Further research is requir ed to delineate the precise role of PRNs for challenging behaviours in this population, and to determine if PRNs can be used along with other modes of therapeutic interventions, instead of administering neuroleptics on a regu lar basis for this indication.