The international consensus process on psychopharmacology and intellectual disability.
A 1997 expert handbook warned us to tread carefully with mind drugs for ID, and later studies show we still over-use them.
01Research in Context
What this study did
A panel of 60 experts from 17 countries met for three years. They wrote 21 short reports on using mind-affecting pills for people with intellectual disability.
The goal was to agree on when to start, stop, or switch these drugs. The panel looked at research up to 1997.
What they found
The experts agreed on basic rules. Start low, go slow, watch side effects, and pair pills with behavior plans.
They said we need more studies on what works and what harms.
How this fits with other research
Scheifes et al. (2013) later counted kids in homes. One in three were on these pills, just like the handbook feared.
Klein et al. (2024) tracked youth in Canada. They found even more kids on two or more drug types at once. This shows the 1997 warnings about polypharmacy came true.
Dolezal et al. (2010) focused on clozapine. They found no clear proof it helps behavior, backing the handbook’s call for better data.
Why it matters
The 1997 handbook still rings true. Pills are easy to start and hard to stop. Use the rules to protect your clients. Check drug lists every six months. Ask, "Does this pill still help?" If you can’t answer, taper and collect data. Your review may be the only safety check the client gets.
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02At a glance
03Original abstract
The present authors invited 115 scientists, practitioners and consumers from 11 nations to form an international consensus panel on best practices and clinical effects regarding psychoactive medicines and intellectual disability. Co-sponsors included the American Association on Mental Retardation, the American Psychiatric Association, the American Psychological Association, the National Institute of Mental Health, the National Association on Dual Diagnosis and The Arc of the United States. The panel developed 21 reports that were revised to reflect comments from 351 participants at a 1995 Ohio State University conference in Columbus, OH, USA. The reports will be published as chapters in a forthcoming book entitled Psychotropic Medication and Developmental Disabilities: The International Consensus Handbook. The need for research and training programmes is discussed.
Journal of intellectual disability research : JIDR, 1997 · doi:10.1111/j.1365-2788.1997.tb00736.x