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Can J Psychiatry. 2018 Jun;63(6):361-369. doi: 10.1177/0706743717727240. Epub 2017 Aug 22.

Antipsychotic Use With and Without Comorbid Psychiatric Diagnosis Among Adults with Intellectual and Developmental Disabilities.

Lunsky Y1,2,3, Khuu W2, Tadrous M2,4,5, Vigod S2,3,6,7, Cobigo V2,8, Gomes T2,4,5,7.

Author information

1
1 Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
2
2 The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
3
3 Department of Psychiatry at the University of Toronto, Toronto, Ontario, Canada.
4
4 Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
5
5 Leslie Dan Faculty of Pharmacy at the University of Toronto, Toronto, Ontario, Canada.
6
6 Women's College Hospital, Toronto, Ontario, Canada.
7
7 Institute of Health Policy, Management, and Evaluation at the University of Toronto, Toronto, Ontario, Canada.
8
8 School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.

Abstract

OBJECTIVE:

Antipsychotic use is controversial in the management of adults with intellectual and developmental disabilities (IDD) because of inconclusive evidence for efficacy in the absence of a comorbid psychiatric condition, and substantial concerns about adverse effects. We aimed to characterize antipsychotic use among Ontario adults with IDD and compare profiles of those with and without a documented psychiatric diagnosis.

METHOD:

This population-based study included 51,881 adults with IDD under 65 y as of April 2010 receiving provincial drug benefits in Ontario who were followed until March 2016 to identify those dispensed at least one antipsychotic medication. Profiles of those with and without a psychiatric diagnosis were compared.

RESULTS:

Overall, 39.2% of adults ( n = 20,316) were dispensed an antipsychotic medication, which increased to 56.4% in a subcohort residing in group homes. Almost one-third (28.91%) of people prescribed an antipsychotic medication did not have a documented psychiatric diagnosis. Those without a psychiatric diagnosis differed considerably from those with a diagnosis. In particular, those without a psychiatric diagnosis were older, less likely to have used antidepressants or benzodiazepines in the year before, and less likely to have used ambulatory and acute care.

CONCLUSIONS:

Antipsychotic use in IDD is common, and occurs frequently without a psychiatric diagnosis. Attention toward how antipsychotics are prescribed and monitored for people with IDD in Canada is warranted to ensure appropriate prescribing.

KEYWORDS:

antipsychotics; intellectual and developmental disabilities; pharmacoepidemiology

PMID:
28830241
PMCID:
PMC5971404
DOI:
10.1177/0706743717727240
[Indexed for MEDLINE]
Free PMC Article

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