Withdrawing Antipsychotics for Challenging Behaviours in Adults with Intellectual Disabilities: Experiences and Views of Experts by Experience

Round 1

Reviewer 1 Report

Thank you very much for giving me the opportunity to review your manuscript. Withdrawal of antipsychotics in people with intellectual disabilities and challenging behaviour is a regular discussion´s topic, which raises some doubts in the daily practice. On the other hand, take into account the subjective opinion of the participants about this question is something, is something that I consider really important to improve our daily work. 

In spite if that, I have some recommendations, which I consider could help to improve the quality of the manuscript. 

Introduction: 

I miss some references in the introduction about underlying psychiatric disorders, which could play a role in challenging behaviour in people with intellectual disabilities (for instance, affective or psychotic disorders). I find also a lack of information about autism spectrum disorders and challenging behaviour. It would be not the same withdraw psychotropic drugs in a pacient with ASD, ID and challenging behaviour or with a comorbid psychotic disorder, than in somebody without. Some useful references could be: Peña-Salazar et al. (2020), Peña-Salazar et al. (2022), Mc Carthy et al (2010), Mazza et al. (2020).

Methods: I would include the psychiatric diagnosis of the participants in this study. 

Discussion: I consider, the discussion could be enriched with the inclusion of some references about challenging behaviour and comorbid psychitric disorders. 

Thank you very much,。

Author Response

Please check the attached file.

Author Response File: Author Response.pdf

Reviewer 2 Report

I think this is a well-written paper, of importance - given initiatives to redue antipsychotic prescribing - and of interest to the readers. I only have minor comments on how it could be improved.

- I think that reference to the STOMP initiative would help to set the scene for the move towards describing antipsychotics.

- The gender/age distribution looks sensible but I suspect that all participants were white. I think this should be specified as a limitation.

- Six interviews seems low (to me) to reach saturation. Are the authors confident that this is sufficient?

- (Very minor) There is a closing " ' " missing on line 47.

Author Response

Please check the attached file.

Author Response File: Author Response.pdf