Prevalence of psychotropic drug use in adults with intellectual disability: positive and negative findings from a large scale study.
In a huge New York sample, six out of ten adults with ID take psychotropics, but half now target real mental illness, not just behavior.
01Research in Context
What this study did
Fahmie et al. (2013) mailed surveys to every agency that serves adults with intellectual disability in New York State.
They asked about 4,069 adults and whether each person took any psychotropic drug.
The team also recorded if the drug matched a real psychiatric diagnosis or was only for behavior control.
What they found
Fifty-eight out of every 100 adults received at least one psychotropic medication.
Antipsychotics were the most common; thirty-nine out of every 100 took them.
Half of the prescriptions now listed a diagnosed mental-health condition as the reason, not just problem behavior.
How this fits with other research
Cerutti et al. (2004) tracked the same group earlier and saw almost the same rate, so use has stayed flat for a decade.
Christian et al. (1997) found only thirty-eight percent in group homes, showing the newer number is markedly higher.
Axmon et al. (2017) looked at older adults with ID plus dementia and still saw heavy prescribing, hinting the trend continues with age.
Congiu et al. (2010) warn that more drug classes raise side-effect scores, so the higher rate in A et al. may bring more harm.
Why it matters
You will see meds on most behavior plans, so always ask for the psychiatric diagnosis that justifies each drug. Push the team to taper when the reason is only “aggression” with no Axis-I condition, and schedule side-effect checks if the person takes more than one class.
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02At a glance
03Original abstract
The use of psychotropics by categories and the reason for their prescription was investigated in a large scale study of 4,069 adults with ID, including those with autism spectrum disorder, in New York State. Similar to other studies it was found that 58 % (2,361/4,069) received one or more psychotropics. Six percent received typical, while 39 % received atypical antipsychotics [corrected]. There was greater use of antidepressants (23 %), mood stabilizers (19 %), and antianxiety agents (16 %) relative to other studies. The use of anti-impulsives, stimulants and hypnotics was rare (1-2 %). Half of the psychotropics were prescribed for treatment of major psychiatric disorders, 13 % for control of challenging behaviors, and 38 % for both. Results indicated that the major psychiatric disorders, except anxiety disorder and autism, influenced the use of psychotropics and the number of medication used. These findings imply that although practitioners still rely too heavily on the use of antipsychotics in this population, there is a welcome shift in the prescription patterns relative to other studies. The practitioners appeared to use psychotropics primarily to treat diagnosed psychiatric disorders and not just to control aggressive behavior which suggests that evidence-based practice of psychiatry is playing an increasing role in the ID population.
Journal of autism and developmental disorders, 2013 · doi:10.1007/s10803-012-1617-6