Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) and clomipramine have the biggest body of evidence for use in managing behaviour that challenges (unlicensed use).

As with antipsychotics, the mechanism of action is poorly understood and could just be the result of lifting underlying low mood and anxiety. The SSRIs in particular may have a role in the management of self-injurious behaviour by reducing obsessive tendencies.

Mood stabilisers

Mood stabilisers is a name given to medicines that can be used to treat mania and bipolar disorder. They include lithium and the anti-epileptic drugs carbamazepine, valproate and lamotrigine. With the higher incidence of epilepsy in people with a learning disability, great care is needed to find out and record whether the medicine is being used to treat epilepsy, bipolar disorder or behaviour that challenges. Use in behaviour that challenges is unlicensed.