Longitudinal prescribing patterns for psychoactive medications in community-based individuals with developmental disabilities: utilization of pharmacy records.
Community adults with IDDD are prescribed psychoactive drugs at high and rising rates, often three at once.
01Research in Context
What this study did
The team looked at pharmacy records for 2,344 adults with intellectual or developmental disabilities living in the community.
They tracked every prescription filled over 17 months and counted how many were for psychoactive drugs.
What they found
More than half of all prescriptions were psychoactive. Six out of ten people took two or more of these drugs at the same time.
Olanzapine, risperidone, valproic acid, and clonazepam were prescribed more often as the months went by.
How this fits with other research
Christian et al. (1997) saw the same pattern in North Dakota group homes. Their rate was 38%, close to the 52% found here, showing high use in both settings.
Fahmie et al. (2013) repeated the count nine years later in New York. The share stayed near 58%, but now half the prescriptions listed a clear psychiatric diagnosis instead of just "behavior control."
Branford (1997) followed adults moving out of institutions. Drug counts did not drop after the move, foreshadowing the high community numbers seen in this paper.
Li et al. (2025) looked at hospitalized children with autism in China. A striking 97% received psychoactive meds, showing the trend extends to youth and inpatient care.
Why it matters
If you write behavior plans, you will often serve clients who take two, three, or more psychoactive drugs. Use this fact when you set baseline behavior levels and watch for side effects that can mimic or mask behavioral functions. Pair your data with nurses or physicians so changes in medication appear in your graphs and decisions.
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02At a glance
03Original abstract
BACKGROUND: Little is known about longitudinal prescribing practices for psychoactive medications for individuals with intellectual disabilities and developmental disabilities (IDDD) who are living in community settings. METHODS: Computerized pharmacy records were accessed for 2344 community-based individuals with IDDD for whom a total of 3421 prescriptions were written during a 17-month period of study. Forty-two psychoactive medications were rank ordered in terms of prescription frequency. RESULTS: Fifty-two per cent (52%) of all prescriptions written during the study period were for psychoactive medications. Anticonvulsant, antipsychotic and antidepressant medications were the most commonly filled prescriptions among psychoactive medications. Sixty per cent (62%) of the study population was given prescriptions for more than one psychoactive medication and 36% received three or more psychoactive medications. During the study period there was a statistically significant increase in prescriptions filled for olanzapine, risperidone, valproic acid, and clonazepam whereas prescriptions filled for thioridazine, haloperidol, and benzotropine showed a significant decline (P < 0.05-0.001). Distribution of psychoactive drug class by age showed that the majority of prescriptions were filled for individuals between 20 and 50 years with the exception of prescriptions for psychostimulants which peaked for individuals prior to 20 years. CONCLUSIONS: (1) Analysis of pharmacy billing records provides a method for assessing prescribing patterns of psychoactive medications in community-based individuals with IDDD. (2) Polypharmacy for psychoactive medications is prevalent in this setting. (3) The second-generation antipsychotic medications are prominently represented by an increasing number of filled prescriptions during the study period.
Journal of intellectual disability research : JIDR, 2004 · doi:10.1111/j.1365-2788.2004.00625.x