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The Hit and Miss of Magic Bullets: A Guide to Psychotropic Medication for Young People with Intellectual Handicap

Royal Alexandra Hospital for Children, Sydney, Australia, davidd{at}mail.kids.usyd.edu.au

Psychotropic medication has a discrete but valuable role in the treatment of psychiatric problems of young people with intellectual handicap. This review argues in favour of the responsible use of psychotropic medication in the management of these problems and describes some of the complexities of psychiatric assessment in this population. Two clinical cases are presented. The first illustrates how helpful psychotropic medication can be. The second illustrates some of the difficulties in diagnosis. This review considers the complexity of biopsychosocial assessment, the limitations of diagnoses and some guidelines for treatment and prescribing. A brief overview of drug groups is provided. The result is a guide to a contentious subject which addresses issues of uncertainty in assessment, diagnosis, causal mechanisms, pharmacology, consent and evaluation in the context of alternative approaches.

Key Words: behaviour disorder • intellectual handicap • neuropsychiatry • psychotropics

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