Medication Pathway

Section B Medication Facts and National Guidance

Guidance on prescribing antipsychotic medication

The National Institute for Health and Care Excellence (NICE) sets guidelines on how medication should be used for people with a learning disability, autism or both. This includes guidelines about using medication to reduce challenging behaviour and treating people with a learning disability, autism or both who have a mental health need. The guidance is clear that antipsychotic medication should only be used for challenging behaviour if:

  • Psychological or other interventions alone do not reduce the challenging behaviour within an agreed time, or
  • Treatment for any mental or physical health problem has not led to a reduction in the behaviour, or
  • The risk to the person or others is severe (for example because of harming others or self-injury).

Practice guidelines from the Royal College of Psychiatrists also give advice on prescribing psychotropic medication for people with a learning disability, autism or both. This includes the need for regular reviews of psychotropic medication. They advise that if the medication has not had its desired effect in three months, then it should be stopped and other options considered. Best practice would be that alternatives to medication are always considered before and during prescription, as well as after any medication has been reduced or stopped. The review schedule is set out clearly in NICE guidance and is discussed in Section E.