Unlicensed applications of licensed psychotropic drugs in an intellectual disability clinical service: retrospective case-note study

Abstract

Prescribing of psychotropic drugs for unlicensed indications is common in inpatients with intellectual disability, but the frequency in the community is uncertain. This study examined the medical records of all patients undergoing review within a single service led by a consultant psychiatrist. The notes of 114 individuals with varying degrees of disability and independence were available. In 78 percent of individuals the cause of disability was uncertain; 72, 69 and 78 percent had mental health problems, physical ill-health and behavioural challenges respectively; and 66 percent received licensed drugs for unlicensed applications, principally for aggression, risperidone being the drug most prescribed. There were no significant differences between groups with mild, moderate or severe disability in the proportion receiving licensed and unlicensed prescriptions. Unlicensed prescribing was similarly common for patients living in different settings. Prescribing for unlicensed applications in patients with intellectual disability is common, regardless of degree of disability or place of residence.