[Inappropriate prescribing of antipsychotics to people with a mental disability and aggressive behavioural disorders]

A recent study showed that prescribing antipsychotics to mentally disabled patients with aggressive behavioural disorders is not effective. However, prevalence of antipsychotics use is high in this group because non-pharmacological treatments are often unavailable; establishing a diagnosis is very complex and there is often peer pressure to prescribe drugs. Mentally disabled patients are frequently excluded from randomized controlled trials. Therefore, no or limited evidence is available on the safety and efficacy ofpsychotropic drugs in this population. Physicians should reduce and discontinue the prescription of antipsychotics to patients with an aggressive behavioural disorder and if necessary refer them to specialized centres to examine their behavioural disorder. Pragmatic trials and observational pharmacoepidemiological studies may contribute to the evidence-based prescription of psychotropics in mentally disabled.