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This case report highlights the complex factors in prescribing psychotropic medication for people with intellectual disability with significant co‐morbid physical and mental health problems. The case study is of a young man with a mitochondrial disorder, secondary sensory impairments, mild intellectual disability, epilepsy and autism spectrum disorder who developed a psychotic illness. The report focuses on the use of psychotropic medication in this man and discusses the issues regarding psychotropic medication that need to be considered with service users and their carers.

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