de Kuijper G, Degraeve G, Zinkstok J R
Tijdschr Psychiatr. 2019;61(11):786-791.
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.
在智力残疾（ID）患者中，精神药物的处方往往是长期的，且超出了许可的适应症范围。
为智力残疾患者开具精神药物提供实用策略。
我们回顾了文献和现有指南，以总结智力残疾患者精神药物处方的建议。
《智力残疾诊断手册》是促进智力残疾患者精神障碍诊断的有用工具。没有精神疾病时的挑战性行为不是开具精神药物的许可适应症。由于智力残疾患者副作用的易感性增加，在开具精神药物之前进行风险效益分析至关重要。根据现有指南，我们建议使用适用于智力残疾的标准化量表监测治疗和不良反应。
对于智力残疾患者，在开始和持续用药时进行仔细的决策过程对于防止药物治疗不足和过度至关重要。
