Psychotropic medication in adults with mental retardation: prevalence, and prescription practices.
One Norwegian county showed that more than a third of adults with ID take psychotropics, often without a clear reason, and later studies say the share is rising.
01Research in Context
What this study did
Holden et al. (2004) counted every adult with intellectual disability in one Norwegian county. They asked doctors and caregivers which pills each person took. The team focused on psychotropics: drugs for mood, behavior, or thinking.
They also checked if a doctor had written a clear diagnosis or follow-up plan before handing out the pills.
What they found
Thirty-seven out of every 100 adults with ID were on at least one psychotropic drug. Many of these prescriptions came from family doctors, not psychiatrists. Often there was no written diagnosis or review in the chart.
How this fits with other research
Garwood et al. (2021) later asked the same question in Germany and saw the rate jump to 54%. The higher number extends the Norwegian warning: the problem is growing, not shrinking.
Heald et al. (2020) zoomed in on people taking two or more psychotropics at once. They found that twenty-three percent of adults with ID are in that risky boat. Børge’s snapshot now looks like the tip of a polypharmacy iceberg.
Agiovlasitis et al. (2025) added hope. After brief staff training in the UK, twice as many adults had their antipsychotic dose lowered within six months. The same surveys that show high use also show we can reverse it.
Why it matters
If more than one in three of your adult clients swallow psychotropics, some may be on them for convenience, not need. Ask to see the prescription label and the matching diagnosis. Schedule a medication review before you write a new behavior plan. Push for data: are side effects clouding learning? These simple checks can protect your client and boost the power of your ABA program.
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02At a glance
03Original abstract
People with mental retardation comprise an overmedicated population. Studies the last 20 years or so indicate that nearly 50% of people with mental retardation receiving care have been using psychotropic medication, in the treatment of psychiatric disorders and/or problem behaviours. The recent years guidelines for prescription of psychotropics have been developed, emphasizing, e.g. the presence of a diagnosis, consideration of alternatives, and evaluation. In spite of all this, we found that 37% of people with mental retardation in one Norwegian county were using psychotropics, mostly neuroleptics. Moreover, prescriptions frequently violated current guidelines, especially when conducted by general practitioners. For example, a lot of prescriptions had not been indicated by a diagnosis, alternatives to medications had rarely been explored, and evaluation of effects and side effects were exceptions. Psychiatrists complied more with current guidelines. Implications of the findings are discussed.
Research in developmental disabilities, 2004 · doi:10.1016/j.ridd.2004.03.004