Practical guidelines for the use of new generation antipsychotic drugs (except clozapine) in adult individuals with intellectual disabilities.
Print the drug-utilization review forms and schedule quarterly checks to keep antipsychotic use safe and lean.
01Research in Context
What this study did
de Leon et al. (2009) wrote a how-to guide for doctors.
They picked six new antipsychotics: risperidone, aripiprazole, olanzapine, quetiapine, paliperidone, and ziprasidone.
The guide gives start-up doses, titration steps, and ready-made forms to track weight, blood sugar, and side effects in adults with intellectual disability.
What they found
The paper does not give new trial data.
It pulls existing safety reports into one folder of checklists you can print and stick in a chart.
How this fits with other research
Matson et al. (2011) looked only at kids and found risperidone beats placebo for behaviour, but kids gained weight.
Jose’s guide takes the same drug into adulthood and adds monitoring sheets so you catch that weight gain early.
Spanoudis et al. (2011) audited UK services two years later and saw most prescribers already followed dose rules like Jose’s, yet side-effect checks were still hit-or-miss.
Agiovlasitis et al. (2025) ran a staff-training program that doubled antipsychotic dose reductions in community homes, showing the guide’s monitoring loop can shrink unnecessary use when teams actually use it.
Why it matters
If you serve adults with ID, keep Jose’s forms in the behaviour plan folder.
Use them at baseline, week four, and every three months after.
When weight climbs or sedation spikes, you have numbers to show the prescriber and can push for a behaviour-analytic review instead of another pill.
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Join Free →Open the chart, fill out the baseline monitoring sheet, and book the first follow-up call with the prescribing doctor.
02At a glance
03Original abstract
New generation antipsychotic (NGA) drugs introduced to the US market after clozapine (aripiprazole, olanzapine, paliperidone, quetiapine, risperidone, and ziprasidone) are frequently used in individuals with intellectual disabilities (ID). However, there is very limited research to fully establish evidence-based or personalized medicine approaches for their use in this population. These guidelines take a pragmatic approach to establishing frameworks for their use by utilizing the prescribing information and reviewing the available literature on other relevant neuropsychiatric disorders. In the absence of expert consensus guidance and well-controlled comparison trials, we present a set of guidelines to inform initiation, dosing and monitoring of use in adults. Further, in these guidelines we provide practical information on drug-drug interactions and adverse drug reactions, and a brief review of discontinuation syndromes, potential for abuse, use during pregnancy and cost considerations. We also provide drug utilization review forms for each NGA to facilitate implementation of these guidelines, these guidelines provide a practical and necessary resource for practitioners treating psychiatric disorders and challenging behaviors in adult individuals with ID.
Research in developmental disabilities, 2009 · doi:10.1016/j.ridd.2008.10.010