Monitoring for Metabolic Syndrome in Adults with Intellectual Disability on Atypical Antipsychotic Drugs

Devapriam, John; Anand, Amit; Raju, Lammata Bala; Bhaumik, Sabyasachi

doi:10.1179/096979509799103151

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…With regard to metabolic side effects, we found that blood pressure had not been measured in 6 out of 10 individuals, and for 4 out of every 10 there was no evidence that they had been weighed, or that blood glucose or lipids had been checked. These findings are in line with a recent audit of monitoring of the metabolic syndrome (Devapriam et al . 2009), which revealed that less than 15% of adults with ID prescribed SGAs had all the parameters of metabolic syndrome monitored on a regular basis.…”

Section: Discussionsupporting

confidence: 92%

Nature and quality of antipsychotic prescribing practice in UK psychiatry of intellectual disability services

Paton

Flynn

Shingleton-Smith

et al. 2011

J intellect Disabil Res

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Section: Discussionsupporting

confidence: 92%

Nature and quality of antipsychotic prescribing practice in UK psychiatry of intellectual disability services

Paton

Flynn

Shingleton-Smith

et al. 2011

J intellect Disabil Res

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“…Baburaj and El Tahir (2011) followed up 32 patients with intellectual disability, who were given antipsychotic medication and found that only 21% received 4-month monitoring, while 25% received annual review and suggest that there is inadequate monitoring for metabolic syndrome in this population. Devapriam et al (2009) also found that there was inadequate monitoring of people with intellectual disability given atypical antipsychotic medication in spite of the evidence that these people are more prone to weight gain and physical health problems. Our results reflect national trends and the clear need to develop integrated models of care which target the physical health of people with intellectual disability with severe mental illness as they have a shorter life expectancy and increased risk of early death when compared with the general population (Hollins et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Monitoring metabolic side effects of atypical antipsychotics in people with an intellectual disability

Teeluckdharry

Sharma

O’Rourke

et al. 2013

J Intellect Disabil

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This audit was undertaken prospectively to examine the compliance of a group of psychiatrists against guidelines they developed for monitoring the onset of metabolic syndrome, a potential side effect of antipsychotic medication, especially second generation or atypical ones. Phase 1 of the audit was to set standards by a questionnaire survey of participating psychiatrists against Consensus Guidelines on monitoring (American Diabetic Association, 2004), which they favoured. The results led to modifying these guidelines to develop minimum acceptable standards against which their practice was audited in Phase 2. Although in Phase 1, 77% of the psychiatrists felt that they did some baseline recording, Phase 2 finding did not corroborate this--only 53.8% of the notes recorded the assessment of risk factors in personal history; 37.5% risk factors in family history; 31.7% baseline weight and 26.4% baseline blood sugar/lipid levels. In Phase 1, 85% of the psychiatrists thought that they carried out some of the recommended monitoring; our audit found the records of weight monitoring in 69.7% of the notes and blood sugar and lipids monitoring in 44.2%. People with intellectual disability have a shorter life expectancy and increased risk of early death when compared with the general population. Obesity is already a health issue for people with intellectual disability. We discuss the challenges faced by psychiatrists in implementing their own minimum acceptable standards and suggest measures to reduce the metabolic risk associated with antipsychotic medication through increasing awareness--use of information leaflets in accessible format, health promotion and use of side effect checklists and improving access--by working collaboratively with general practitioners utilising the forum of annual health checks.

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“…10,11 This lack of data is confirmed, within a clinical setting, by a recent audit showing that only 3% of individuals with intellectual disability starting an atypical antipsychotic and 1% during follow-up had undergone monitoring of blood glucose, lipids and body weight. 12 In this paper we describe the first study on the metabolic and endocrine profiles of a representative intellectual disability cohort compared with a general population control group, and between participants with intellectual disability on antipsychotics and those who were antipsychotic naive.…”

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confidence: 99%

Safety of antipsychotics in people with intellectual disability

et al. 2011

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Antipsychotics, on average, did not increase metabolic risk,although the existence of a susceptible subgroup at risk of diabetes cannot be excluded. Some antipsychotics induced hyperprolactinaemic hypogonadism, requiring active management. However, our findings suggest that antipsychotics at the low doses routinely prescribed for people with intellectual disability are generally safe in relation to metabolic adverse effects, even if efficacy remains poorly defined.

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Monitoring for Metabolic Syndrome in Adults with Intellectual Disability on Atypical Antipsychotic Drugs

Cited by 7 publications

References 25 publications

Nature and quality of antipsychotic prescribing practice in UK psychiatry of intellectual disability services

Nature and quality of antipsychotic prescribing practice in UK psychiatry of intellectual disability services

Monitoring metabolic side effects of atypical antipsychotics in people with an intellectual disability

Safety of antipsychotics in people with intellectual disability

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