Antipsychotic medication prescription patterns in adults with developmental disabilities who have experienced psychiatric crisis.

Lunsky et al. (2012) looked at prescription records after adults with developmental disabilities had a psychiatric crisis. They counted how many people left the hospital with antipsychotic orders and who got more than one drug at the same time.

The team also checked if gender, living place, past stays, or other mental-health labels predicted who received the medicines.

Almost half of the adults were placed on antipsychotics right after the crisis. One in five of those people had two or more antipsychotics ordered together.

Men, people in group homes, people with extra psychiatric labels, and people with past hospital stays were the most likely to receive the drugs.

Fyfe et al. (2007) reviewed every controlled trial and found only one small study that says risperidone helps adults with ID and aggression. That review tells doctors to run a fresh FBA before writing any script. Yona’s real-world chart study shows the warning is still ignored five years later.

Eussen et al. (2016) later tracked 826 Medicaid members with developmental disabilities and saw the same 60% prescribing rate. The close match turns Yona’s single-crisis snapshot into a steady system-wide pattern.

Laermans et al. (2025) flipped the script. They slowly reduced off-label antipsychotics in 25 adults with ID and saw better quality of life and less challenging behavior. Their taper success sits beside Yona’s high-use numbers and shows polypharmacy can be undone.

If you serve adults with IDD, expect half of your new referrals to already be on antipsychotics. Pull the med list at intake, flag duplicate agents, and share recent behavior data with the prescriber. Pair your functional assessment with P et al.’s taper plan so you can safely cut doses while teaching replacement skills. Every pill you help remove is one less metabolic risk for the client.