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Antipsychotic Rx Still Common With Intellectual Disabilities

TUESDAY, Sept. 15, 2020 -- Antipsychotic drug prescription is still common for people with intellectual disabilities, according to a study published online Sept. 10 in BMJ Open.

Angela Henderson, from the University of Glasgow in the United Kingdom, and colleagues assessed trends in psychotropic prescribing among 1,190 adults with intellectual disabilities in 2002 to 2004 (T1) and 3,906 adults with intellectual disabilities in 2014 (T2).

The researchers found that 50.7 percent of adults in T1 and 48.2 percent in T2 were prescribed at least one psychotropic, including antipsychotics (24.5 percent in T1 and 16.7 percent in T2) and antidepressants (11.2 percent in T1 and 19.1 percent in T2). Among those prescribed antipsychotics in T1, 21.2 percent had psychosis or bipolar disorder, 33.2 percent had no mental ill health or problem behaviors, and 20.6 percent had problem behaviors but no psychosis or bipolar disorder. From T1 to T2, prescriptions for psychotropics increased from 47.0 to 57.8 percent, while antipsychotic prescribing did not change (odds ratio [OR], 1.18; 95 percent confidence interval [CI], 0.87 to 1.60; P = 0.280). Increases were seen for antidepressants (OR, 2.80; 95 percent CI, 1.96 to 4.00; P < 0.001), hypnotics/anxiolytics (OR, 2.19; 95 percent CI, 1.34 to 3.61; P = 0.002), and antiepileptics (OR, 1.40; 95 percent CI, 1.06 to 1.84; P = 0.017). For people with problem behaviors in T1, antipsychotic prescribing increased (OR, 6.45; 95 percent CI, 4.41 to 9.45; P < 0.001); this increase was higher than that seen for people with other mental ill health in T1 (OR, 4.11; 95 percent CI, 2.76 to 6.11; P < 0.001).

"This study has shown that fewer new antipsychotic prescriptions are being initiated, but patients prescribed antipsychotics in T1 were unlikely to have these drugs withdrawn over the next decade," the authors write. "This study reinforces the need for frequent medication reviews for people with intellectual disabilities, alongside further research to investigate the long-term effects of antipsychotic medications on this population."

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Posted: September 2020

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