Key points

Key points

  • There is evidence of widespread prescribing of psychotropic medicines (antipsychotics, antidepressants and hypnotics) for people with learning disabilities, many of whom do not have relevant indications recorded for the psychotropic medicines they are prescribed. The use of most psychotropic medicines to manage challenging behaviour in people with learning disabilities is an off-label[1] use of a licensed medicine.

  • People with learning disabilities may benefit from referral to a learning disability team for specialist review to minimise the use of psychotropic medicines.

  • Antipsychotic medication should only be considered to manage behaviour that challenges in people with learning disabilities when other interventions have not been helpful and when the risk to the person or others is very severe. They should only be offered in combination with psychological or other interventions to help manage challenging behaviour.

  • Learning disability features in the NHS Long Term Plan published in January 2019.

  • Options for local implementation:

    • Review and, if appropriate, optimise prescribing and local policies relating to the treatment of challenging behaviour in people with learning disabilities to ensure these are in line with the NICE guideline on challenging behaviour and learning disabilities.



[1] In line with the guidance from the General Medical Council (GMC) on prescribing unlicensed medicines, the prescriber should take full responsibility for determining the needs of the patient and whether using a medicine outside its authorised indications is suitable.