Psychopharmacotherapy in children and adults with intellectual disability

The prevalence of psychiatric disorders is increased in children and adults with intellectual disability. Brain damage or dysfunction interact with so cial and family factors to increase susceptibility to mental illness. Psych iatric disorders in the context of genetic syndromes are commonly overlooke d, and there is substantial underdiagnosis of mental disorders because of t he atypical and non-specific clinical presentations, and the frequent assum ption that psychiatric symptoms are an inherent part of the underlying inte llectual disability. There is a strong need for evidence-based practice in the prescribing and monitoring of drugs in this population, especially sinc e many of the drugs are unlicensed for use in children. There is an urgent need to understand and establish the pharmacokinetics, pharmacodynamics, an d side-effect profiles of psychotropic medication in this population. Posit ive trends in pharmacotherapy include the use of atypical antipsychotics in stead of the classic antipsychotics, serotonin-specific reuptake inhibitors (SSRIs) rather than tricyclic antidepressants, and newer antiepileptic dru gs. Another welcome trend is the use of SSRIs instead of antipsychotics in the long-term management of challenging behaviour in this population.