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Reports of the prevalence of psychotropic medication use in persons with intellectual disability consistently demonstrate that upward of one-third of this population, both children and adults and across residential settings, is receiving at least one psychotropic drug. The general tone of these reports suggests alarm, for example, that the population is "overmedicated" (Holden and Gitlesen 2004) and that drug use is imprecise and appears not to be specific to diagnosis (Shireman et al. 2005; Singh et al. 1997). Psychostimulants, antidepressants, antipsychotics, and anticonvulsants comprise the vast majority of psychotropic medication prescriptions in intellectual disability (Shireman et al. 2005). With respect to the perceived lack of specificity with which psychotropic medications are employed—for example, the off-label use of medications in intellectual disability for the treatment of target symptoms like aggression, hyperarousal, and behavioral disturbance (Haw and Stubbs 2005)—the picture is complicated. Moreover, risperidone, an atypical antipsychotic, has a U.S. Food and Drug Administration (FDA)–approved indication for the treatment of irritability, aggression, and self-injurious behavior in children with autism. As our knowledge of the underlying causes for specific intellectual disability syndromes grows, we are likely to see an even greater uncoupling of drug and mental disorder in favor of drug and disability syndrome.

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