Changing Patterns of Psychotropics Use Among Older Adults With Intellectual Disability Over a Decade, With a Focus on Designated Mental Health Conditions.
Ashleigh Gorman, Marina Odalović, Aviejay Paul and 11 others
PMID 41607351WHAT IT FOUND
Psychotropic use remained high in older adults with intellectual disability over a decade.
Antipsychotic and sedative use dropped, while antidepressant use rose. Many people taking these drugs had no diagnosed mental health condition, but did have behaviours of concern.
Key findings
01Overall psychotropic use did not change significantly over the decade, remaining high at 59.2% in 2009/10 and 56.5% in 2019/20.
02Prescribing patterns shifted: antipsychotic use fell from 43.3% to 40.1%, sedative/hypnotic use fell from 13.6% to 8.1%, and antidepressant use rose from 26.2% to 31.8%.
03A third of participants with behaviours of concern but no mental health diagnosis used psychotropics, with antidepressants (19.3%) and antipsychotics (18.1%) being the most common.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Mental health diagnoses were based on self-report or carer report of a doctor's diagnosis, without specifying if the diagnosing doctor was a specialist or a general practitioner. The study could not determine the outcomes of non-pharmacological interventions, so it cannot assess whether these supports reduced the need for medication. The sample may under-represent people with mild intellectual disability who do not require services. The study is observational and cannot prove that changes in prescribing were caused by specific policies or clinical needs.
Declared interests
The study was funded by the Health Research Board and the Department of Health. One author (R.S.) received institutional and research support from several pharmaceutical companies (LivaNova, UCB, Eisai, Veriton Pharma, Bial, Angelini, UnEEG, Jazz/GW pharma) outside this work. No other authors declared conflicts of interest.
The easy way to misread this
Do not assume that the decrease in antipsychotic prescribing reflects a reduction in inappropriate use. Antipsychotics remained the most commonly prescribed psychotropic, and a large proportion of users did not have a diagnosed mental health condition for which the drug is licensed, suggesting they were still being used to manage behaviours of concern.
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