Psychotropic drugs intake in people aging with intellectual disability: Prevalence and predictors

Abstract

Background: Psychotropic medication is frequently administered to people with intellectual disability with mental health and/or behavioural problems, instead of other non-pharmacological interventions. This study describes the mental health and behavioural problems of people aging with intellectual disability, their psychotropic medication intake, and the factors contributing to a greater medication intake. Method:The sample consisted of 991 people with intellectual disability over 45 years. Descriptive statistics and multinominal logistic regression were carried out.Results: Antipsychotics were the most used psychotropic drug. Older people with mild intellectual disability living in institutions and affected by mental health and behavioural problems were more likely to take larger amounts of psychotropic medication.Conclusions: Antipsychotics continue to be widely used by people with intellectual disability and mental and behavioural health problems, especially those in institutionalised settings. Future research should consider if medication intake could be reduced providing better supports in the community and non-pharmacological interventions.

Co-Occurring Mental Illness and Behavioral Support Needs in Adults with Intellectual and Developmental Disabilities

“…Our study descriptively analyzed patterns of psychotropic medication use in our sample. Consistent with the work of other researchers (Esler et al, 2019 ; García-Domínguez et al, 2022 ; Lunsky & Modi, 2018 ) we found widespread use of medications to manage mental health and behavioral conditions, even when formal diagnoses were not noted. We also found that NCI-IPS respondents were more likely to use medications to manage behavioral support needs than they were to have a behavior management plan on file.…”

“…Part of the challenge in determining rates of mental health conditions and behavioral support needs behavior among people with IDD is disentangling the complex relationships between these constructs. For example, higher levels of intellectual disability (severe or profound) were associated with higher rates of documented behavioral support needs (García-Domínguez et al, 2022 ; Kats et al, 2013 ; Scott & Havercamp, 2014 ) and lower rates of mental health diagnoses (Scott & Havercamp, 2014 ), compared with people with mild or moderate IDD. McCarthy et al ( 2010 ) analyzed clinical assessments from a specialist mental health service and reported that more severe levels of ID positively predicted challenging behaviors while a mental health diagnosis did not.…”

“…At the IDD service system level, a prior analysis using NCI-IPS data found that mental health conditions and behavioral challenges were associated with a person’s residence type (García-Domínguez et al, 2022 ; Scott & Havercamp, 2014 ). People with IDD who lived with their families had the lowest rates of mental health conditions compared to all other settings (Scott & Havercamp, 2014 ), though the causes for this relationship were undetermined.…”

“…Under this early conceptualization, challenging behaviors, defined as culturally abnormal behaviors that posed a risk to the individual’s safety or ability to interact with the community (Poppes et al, 2010 ), were attributed directly to a person’s disability (Mazza et al, 2020 ). Recently, terminology has shifted away from labeling behavior as challenging or problematic in recognition that norms are culturally situated and that behavior often serves as communication (Friedman, 2021 ; García-Domínguez et al, 2022 ). We will primarily use the term “behavioral support needs” to reflect the language used in the data sources for this study.…”

Withdrawing Antipsychotics for Challenging Behaviours in Adults with Intellectual Disabilities: Experiences and Views of Prescribers

“…Although it is recommended that long-term off-label psychotropic drug prescription should be discontinued especially antipsychotics, they are still frequently prescribed for the treatment of challenging behaviours [ 34 , 35 , 36 ]. This may, at least partially be, because of failures of successful discontinuation of antipsychotics due to worsening of behaviour upon drug withdrawal [ 37 ].…”