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Stopping inappropriate medication of children with intellectual disability, autism or both: the STOMP–STAMP initiative

Published online by Cambridge University Press:  16 March 2023

Annie Swanepoel Open the ORCID record for Annie Swanepoel [Opens in a new window]  and
Mark Lovell
Annie Swanepoel*
Affiliation:
Consultant child and adolescent psychiatrist with the Southend, Essex and Thurrock Child and Adolescent Mental Health Service, working with children with severe or profound intellectual disabilities across Essex. She is also a member of the Child and Adolescent Intellectual Disability Psychiatry Network (CAIDPN) and the Newsletter Editor for the Evolutionary Psychiatry Special Interest Group at the Royal College of Psychiatrists. She is interested in neurodevelopmental disorders, developmental trauma and evolution.
Mark Lovell
Affiliation:
Dual trained consultant child and adolescent intellectual disability psychiatrist and the child and adolescent mental health service (CAMHS) psychiatry lead with Tees, Esk and Wear Valleys NHS Foundation Trust, working with children and adolescents with mild to profound intellectual disabilities and/or autism in Durham, UK. He is the communications lead for the CAIDPN and the director for CPD and training and board member for the Association for Child and Adolescent Mental Health (ACAMH), and is co-opted to the executive of the Faculty of Child and Adolescent Psychiatry at the Royal College of Psychiatrists. His interests are neurodevelopmental disorders, behaviour that challenges others, research and informatics.
*
Correspondence Dr Annie Swanepoel. Email: annie.swanepoel@nelft.nhs.uk
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Summary

Children with intellectual disability are often prescribed psychotropic medication to manage behaviours that challenge. Unfortunately, many receive medication with potentially serious long-term side-effects that has been prescribed inappropriately or for longer than is necessary. NHS England launched STOMP (stopping the over-medication of people with intellectual disability, autism or both with psychotropic medicines) in 2016 to reduce the inappropriate prescribing in adults. This was broadened to include children in 2018 by the addition of STAMP (supporting treatment and appropriate medication in paediatrics). In this article we review the rationale for STOMP–STAMP, highlight the Royal College of Psychiatrists’ position statement on STOMP–STAMP and give clinical advice for psychiatrists who treat children with intellectual disability, autism and/or attention-deficit hyperactivity disorder (ADHD). Importantly, it is essential to consider that ADHD may have been missed and that by diagnosing and treating it, the need for inappropriate antipsychotic medication may be reduced.

Keywords

Intellectual disabilityautism spectrum disordersattention-deficit hyperactivity disorderantipsychoticsdevelopmental disorders
Type
Article
Information
BJPsych Advances , Volume 29 , Special Issue 5: Neurodevelopmental disorders including intellectual disability: a Clinical Toolkit for Mental Health Professionals (Part 2) , September 2023 , pp. 358 - 366
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

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