Precautions in prescribing psychotropic drugs

People with a developmental disability may not be able to tolerate the physical examination and investigations required to monitor a particular medication (eg lithium). The risks and benefits of taking a medication without the usual capacity for monitoring needs to be discussed with the person and their carers or support people. For advice on facilitating examinations and procedures in people with developmental disability, see Physical examination and investigations.

The doses of psychotropic drugs are the same as for people without developmental disability. However, consider slower titration of drug dosage because the person may have limited ability to report adverse effects. People with developmental disability have a high rate of medical comorbidities (eg physical disorders, congenital anomalies, neurodevelopmental brain abnormalities) and potential for drug interactions that can increase the risk of adverse effects. This may affect medication choice and require more intense monitoring when initiating drugs or making changes.

Assess the capacity of the person with developmental disability to self-monitor and report drug effects, and collaborate with carers or support people if required.

Behavioural change can be a manifestation of distress due to an adverse effect of a psychotropic drug.