Psychotropic Medication Use and Polypharmacy Among Children and Adolescents with Intellectual Disability or Borderline Intellectual Functioning: A Retrospective Cross-Sectional Study

Objective: To describe psychiatric comorbidity, psychotropic medication use, and polypharmacy in children and adolescents with intellectual disability (ID) or borderline intellectual functioning (BIF), and to explore associations with sex and cognitive category.Material and Methods: This single-center, retrospective cross-sectional study included 152 consecutive patients aged 0–18 years with ID or BIF who attended a child and adolescent psychiatry outpatient clinic between January and December 2024. Clinical records were reviewed for sociodemographic characteristics, recorded comorbidities, cognitive category, psychotropic medication use, medication classes, and polypharmacy, defined as concurrent use of at least two psychotropic medications. Exact tests were used when expected cell counts were small, and a Bonferroni-adjusted significance threshold of p < 0.0125 was applied to four principal comparisons.Results: A recorded psychiatric comorbidity was present in 82 patients (53.9%). Psychotropic medication-use data were available for 151 patients; 61 (40.4%) were receiving at least one psychotropic medication, and 25 of 61 medication users (41.0%) received polypharmacy. Antipsychotics were the most frequently recorded class. Psychotropic use did not differ significantly by sex (Fisher exact p = 0.610) or cognitive category (Fisher–Freeman–Halton exact p = 0.069). Polypharmacy also did not differ significantly by sex (p = 0.181) or cognitive category (p = 0.081). The sex comparison for polypharmacy was imprecise (odds ratio = 2.26, 95% confidence interval [0.73, 7.02]).Conclusion: Psychotropic medication use and polypharmacy were frequent in this clinical sample. No statistically significant associations with sex or cognitive category were detected; however, limited subgroup sizes preclude definitive conclusions.