Prevalence and patterns of antipsychotic use and their associations with mental health and problem behaviours among older adults with intellectual disabilities

Abstract

Background There are concerns that antipsychotics may be used inappropriately in adults with intellectual disability for problem behaviours in the absence of a diagnosed mental health condition. The aim was to examine the prevalence and patterns of antipsychotic use and their association with problem behaviours and mental health conditions in older adults with intellectual disability. Methods Cross‐sectional data were drawn from Wave 2 (2013/2014) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA). Medication data were available for 95.6% (n = 677). Those who reported antipsychotic use and reported psychotic or other mental health conditions and those who reported problem behaviours were compared. Results In total, 45.1% (n = 305) had antipsychotics, and of those with antipsychotic use and diagnosis information (n = 282), 25.9% (73) had a psychotic disorder. 58% of those exposed to antipsychotics reported problem behaviours. Conclusion Reported use of antipsychotics significantly exceeded reported doctor's diagnosis of psychotic conditions in this study.

Polypharmacy and psychotropic polypharmacy in adults with intellectual disability: a cross‐sectional total population study

“…People with intellectual disability (ID) have considerably greater health needs than the general population (Hughes-McCormack et al 2018;Kinnear et al 2018;McMahon and Hatton 2020) and are more likely to die at an earlier age than their nondisabled peers (Glover et al 2017;O'Leary et al 2018). They are prescribed more medication than people without IDs, and polypharmacy is common in this population (Emerson et al 2016;O'Dwyer et al 2017O'Dwyer et al , 2019Hove et al 2019). Although polypharmacy may be clinically indicated and considered appropriate (Masnoon et al 2017), the concurrent use of many drugs increases the risk of an individual developing adverse effects and is related to poorer outcomes (O'Dwyer et al 2018).…”

Prevalence of psychotropic medication and factors associated with antipsychotic treatment in adults with intellectual disabilities: a cross‐sectional, epidemiological study in Germany

“…2017; O'Dwyer et al . 2019). Results showed that antipsychotic polypharmacy rate was high and maximum daily doses were frequently exceeded.…”

Etiology and Management of Behavioral Disorder in Adults With Intellectual and Developmental Disabilities

“…Among all patients with ID, approximately 30% regularly use antipsychotics [30] compared to 48% of patients with ID who exhibit significant behavioral problems [31]. The two most frequently used medications are risperidone and aripiprazole, both are administered in a dose lower than that in schizophrenia treatment [32]. These medications are commonly used for the management of ID.…”

“…Previous studies show mixed efficacy when compared to placebo [33][34][35][36]. However, treatment is significantly more effective when used for patients with comorbid psychiatric disorders [32].…”