Psychotropic medicines are defined as medicines that are capable of affecting the mind, emotions, and behaviour of a person and include antipsychotics, antidepressants, mood stabilisers, and psychostimulants, for example methylphenidate, anxiolytics and hypnotics. They act on the central nervous system and can be used to treat mental health disorders.

Antipsychotic medicines have also been prescribed to manage behaviour that challenges in people who have a learning disability. However the use of antipsychotic medicines to manage behaviour that challenges is unlicensed and poorly evidenced with few, if any, good quality studies to demonstrate efficacy. It has been reported that 20 to 45 per cent of people with a learning disability have received psychotropic medicines largely for control of aggression and self-injury. But one of the few randomised controlled trials in this area demonstrated no difference in effect on aggressive behaviour between two different antipsychotics and a placebo.

A diagnosed concurrent mental health disorder is, however, an acceptable indication to use these agents in people with a learning disability. Initiation of antipsychotic treatment should be under the management of a psychiatrist although, once stable, the prescribing and ongoing monitoring can be considered for GP oversight. This allows greater continuity of prescribing with all medicines originating from one source.

A number of recent studies have highlighted and raised concern about the widespread prescribing of psychotropic drugs for people with a learning disability. This includes not just antipsychotics, but also antidepressants, benzodiazepine anxiolytics, and mood stabilisers, often in combination and with additional use of as-required doses.

The NHS England programme Stopping over-medication of people with learning disabilities (STOMPwLD) encourages everyone involved with people with a learning disability receiving psychotropic drugs to play their part to ensure that medicines are reviewed and, if appropriate, facilitate a gradual reduction.