There are many studies of the prescribing of psychotropic medications for people with intellectual disability. This chapter provides data about that prescribing, the issues associated with the data and the trends in usage. Excessive or unnecessary prescribing of psychotropic medication that exposes individuals to unwanted side-effects and imposes unwarranted costs on services has been the focus of many medications review programmes. This section will review outcomes data from medication reduction programmes for individuals with intellectual disability and present practitioner guidelines. The NHS England programme STOMP (Stopping The Over-Medication of People with a learning disability and autistic people) and STAMP (Supporting Treatment and Appropriate Medication use in Paediatrics) has been the focus for many initiatives in England, resulting in the generation of many resources to assist both professions and non-professionals involved with intellectual disability.

The life expectancy for people with intellectual disability is increasing due to advances in medical treatment and social care. However, significant discrepancies in life expectancy between people with intellectual disability and the general population remain, and there continues to be scope to close the inequality gap. This was confirmed in the recent 2021 Learning Disability Mortality Review (LeDeR) report. The standardised mortality ratio for people with intellectual disability ranges from 2–5, which draws a comparison against the general population. Those with additional comorbidities such as epilepsy, genetic syndromes, and functional impairments have a lower age of death. The leading causes of death in older adults (at or over 65 years of age) between 2018 and 2021 were reviewed in the 2021 LeDeR report. In comparison to the general population, a higher proportion of deaths in older intellectual disability adults were due to COVID-19 (coronavirus disease), cancers, and influenza or pneumonia. Unsurprisingly, dementia (in particular Alzheimer’s disease), cerebrovascular disease, chronic lower respiratory tract infections, and diseases of the urinary system were more common causes of death in older intellectual disability compared to that reported in their younger counterparts. This chapter explores the various issues associated with medicating older people.