Psychotropic Use Among Youths With Intellectual and Developmental Disabilities

Psychiatr Serv. 2021 Sep 1;72(9):988-997. doi: 10.1176/appi.ps.201900465. Epub 2021 Apr 22.

Abstract

Objective: The authors examined the prevalence and correlates of psychotropic medication prescribing among outpatient youths with intellectual and developmental disabilities.

Methods: The authors reviewed cross-sectional data on medications for 1,333 youths (ages 5-21 years) with intellectual and developmental disabilities who were referred to a community-based mental health crisis service. Descriptive statistics and regression analysis were used to describe the study group and to identify correlates of psychotropic polypharmacy, antipsychotic use, and anticonvulsant use in the absence of a seizure disorder.

Results: Most youths were taking psychotropic medications (N=1,139, 86%), often three or more medications (N=733, 55%) from two or more drug classes (N=919, 69%). Most youths received antipsychotics (N=863, 65%), and a third (N=432, 32%) were taking anticonvulsants in the absence of a seizure disorder. Greater severity (number of psychiatric diagnoses and recent psychiatric hospitalization), older age, and living in a group home were significantly correlated with these practices.

Conclusions: Polypharmacy, antipsychotic use, and anticonvulsant use in the absence of seizure disorders were common among youths with intellectual and developmental disabilities referred to the crisis service. Older age, number of psychiatric diagnoses, living in a group home, and psychiatric hospitalization correlate with these prescribing practices. These elevated prescribing rates in a very vulnerable population warrant further study.

Keywords: Child psychiatry; Developmental psychiatry; General psychopharmacology; Intellectual disability; Polypharmacy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Developmental Disabilities* / drug therapy
  • Developmental Disabilities* / epidemiology
  • Humans
  • Intellectual Disability* / drug therapy
  • Intellectual Disability* / epidemiology
  • Polypharmacy
  • Psychotropic Drugs / therapeutic use
  • Young Adult

Substances

  • Psychotropic Drugs