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, 6 % received typical, while 39 % received atypical antipsychotics. 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.
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Summary of the 8 MOAS items: attacks others causing mild to severe physical injury; throws or breaks objects, kicks furniture, tears or rips clothes, marks the wall in anger, sets fires; bangs head, hits fist into objects, throws self onto floor or into objects, small cuts or bruises, minor burns, mutilates self, makes deep cuts, bites that bleed, internal injury, fracture, loss of consciousness, loss of teeth.
More precisely, the odds of receiving psychotropic medications for those with bipolar disorder was 5 times the odds of getting the medication for those who did not have bipolar disorder.
Mainly sertraline, paroxetine, fluoxetine, citalopram, escitalopram, trazodone, venlafaxine, buproprion and duloxetine.
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This research was supported by funds from the New York State Office for People with Developmental Disabilities (OPWDD). The authors are grateful to the following Chief Psychologists without whom this project could not have been done: James Baker, Stephen Daurio, Mary Kennedy, Herbert Medetsky, Jerome Meyer, Ron Michelini, Don Morris, Donald Noble, Ed Sorel, Joseph Szempruch, Ann Troy, Susan Verzulli, and Richard Zelhof, and to Christine Muller, OPWDD Research and Analysis Unit, Division of Policy and Enterprise Solutions, for providing the demographics of the population.
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Tsiouris, J.A., Kim, SY., Brown, W.T. et al. Prevalence of Psychotropic Drug Use in Adults with Intellectual Disability: Positive and Negative Findings from a Large Scale Study. J Autism Dev Disord 43, 719–731 (2013). https://doi.org/10.1007/s10803-012-1617-6