Psychopharmacology in mental retardation

Abstract

Purpose of review Psychotropic medications are commonly used in individuals with mental retardation (intellectual disability). The evidence base to guide clinicians in this practice is growing rapidly, in combination with improved recognition of the mental health needs of this population and the availability of new drugs. Recent findings Psychotropic drugs, particularly neuroleptics and anticonvulsants, are frequently prescribed to individuals with intellectual disability. The atypical neuroleptic drugs hold much promise in terms of potential benefit for individuals with significant behavioral disturbances including aggression and self-injury. New anticonvulsants may also find an important place in the treatment of some individuals with mental retardation and epilepsy. Antidepressant and adrenergic medications are also enjoying a growing research database. Nootropic or cognitive-enhancing drugs will probably always be a ‘holy grail’ for the population with intellectual disability, but experience from drug-effects on cognitive impairment in conditions such as schizophrenia may become informative. Knowledge derived from animal models of mental retardation syndromes may also yield new insights for pharmacotherapy. Summary Evidence is accumulating to support the shift from typical to atypical neuroleptic agents in individuals with intellectual disability. However, much work remains with respect to elaborating the knowledge base concerning the use of psychotropic medications in this population. The education of patients and care providers regarding psychotropic medications also needs attention. It remains axiomatic that medication should be used in the context of a comprehensive treatment plan for individuals with mental retardation.