--- - |2+ Background It is unknown why professionals’ adherence to guideline recommendations on antipsychotic drug prescription in the intellectual disabilities care is insufficient. This study aimed to explore barriers and facilitators in the implementation and use of these recommendations. Methods In‐depth interviews with four intellectual disability physicians, two psychiatrists and five behavioural scientists were used to explore the implementation and use of guideline recommendations. Results Barriers in adhering to recommendations were lack of collaboration of different disciplines involved in the treatment of psychiatric and behavioural disorders and lack of enforcement of an appropriate monitoring of side‐ and treatment effects. When guideline recommendations were translated into organizational policies, clinicians were able to divide responsibilities and tasks, needed to appropriately implement guideline recommendations in daily clinical practice. Conclusions To facilitate the use of guideline recommendations, organizations should translate recommendations into organization‐specific policies, involving physicians and behavioural scientists in this process, while simultaneously creating more practical and technological support. - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 6, Page 1062-1070, November 2018.