Neuroleptics, learning disability, and the community: some history and mystery.

Recent papers have again highlighted the consistently high use of neuroleptic agents among people with a learning disability, despite the lack of good evidence to support their role in this population for behaviour management and despite the risks of such medication. Evidence suggests, however, that prescribing habits have remained relatively unchanged; the reasons for this are poorly understood. Given the lack of understanding about the factors contributing to such drug use, and the possibility that use of neuroleptics will increase as people with learning disabilities move into the community, there seems a clear need for clinical guidelines to cover the prescribing and monitoring of neuroleptics within this group. Such guidelines should also ensure that reviews, using reliable measures of treatment efficacy, are carried out regularly.