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 social and family factors to increase susceptibility to mental illness. Psychiatric disorders in the context of genetic syndromes are commonly overlooke...

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Bibliographic Details
Published in:The Lancet (British edition) 1999-07, Vol.354 (9174), p.233-242
Main Authors: Santosh, Paramala Janardhanan, Baird, Gillian
Format: Article
Language:English
Subjects:
Adult
Adults
Antidepressants
Antipsychotics
Biological and medical sciences
Child
Children & youth
Drug therapy
Humans
Intellectual Disability - complications
Intellectual Disability - psychology
Medical sciences
Mental disorders
Mental Disorders - complications
Mental Disorders - drug therapy
Mental Disorders - epidemiology
Neuropharmacology
Pharmacokinetics
Pharmacology. Drug treatments
Prevalence
Psychiatry
Psycholeptics: tranquillizer, neuroleptic
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Psychopharmacology - trends
Psychotropic Drugs - therapeutic use
Side effects
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Summary:The prevalence of psychiatric disorders is increased in children and adults with intellectual disability. Brain damage or dysfunction interact with social and family factors to increase susceptibility to mental illness. Psychiatric disorders in the context of genetic syndromes are commonly overlooked, and there is substantial underdiagnosis of mental disorders because of the atypical and non-specific clinical presentations, and the frequent assumption that psychiatric symptoms are an inherent part of the underlying intellectual disability. There is a strong need for evidence-based practice in the prescribing and monitoring of drugs in this population, especially since many of the drugs are unlicensed for use in children. There is an urgent need to understand and establish the pharmacokinetics, pharmacodynamics, and side-effect profiles of psychotropic medication in this population. Positive trends in pharmacotherapy include the use of atypical antipsychotics instead of the classic antipsychotics, serotonin-specific reuptake inhibitors (SSRIs) rather than tricyclic antidepressants, and newer antiepileptic drugs. Another welcome trend is the use of SSRIs instead of antipsychotics in the long-term management of challenging behaviour in this population.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(98)07059-7