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Safety of antipsychotics in people with intellectual disability
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Safety of antipsychotics in people with intellectual disability
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Journal Article
Safety of antipsychotics in people with intellectual disability
2011
Overview
Despite frequent use, little is known about the metabolic and endocrine side-effects of antipsychotics in individuals with intellectual disability.
To compare indices of obesity, glucose, lipids and prolactin between antipsychotic-treated and antipsychotic-naive individuals with intellectual disability and also between participants with intellectual disability and controls from the general population.
Observational study comparing 138 antipsychotic-treated and 64 antipsychotic-naive participants with intellectual disability in one National Health Service trust with general population controls.
Antipsychotic treatment comprised: risperidone 48%,olanzapine 18%, thioxanthenes 10%, other 24%; monotherapy 95% of participants; mean treatment duration 8 years;median daily chlorpromazine equivalent dose 108 mg(range 16–667). Metabolic indices were the same or more favourable in the intellectual disability group than the general population control group but overweight/obesity and type 2 diabetes were more prevalent in the women in the intellectual disability group than the control group. Metabolic indices were similar, statistically or clinically, between the antipsychotic-treated and the antipsychotic-naive groups but there was a non-significant trend towards a higher rate of type 2 diabetes in the antipsychotic group. A total of 100%and 70% of participants on amisulpride/sulpiride and risperidone respectively had hyperprolactinaemia, with secondary hypogonadism in 77% and 4% of affected women and men.
Antipsychotics, on average, did not increase metabolic risk,although the existence of a susceptible subgroup at risk of diabetes cannot be excluded. Some antipsychotics induced hyperprolactinaemic hypogonadism, requiring active management. However, our findings suggest that antipsychotics at the low doses routinely prescribed for people with intellectual disability are generally safe in relation to metabolic adverse effects, even if efficacy remains poorly defined.
Publisher
Cambridge University Press
Subject
/ Adult
/ Age
/ Aged
/ Alcohol
/ Antipsychotic Agents - adverse effects
/ Antipsychotic Agents - therapeutic use
/ Diabetes
/ Diabetes mellitus (non-insulin dependent)
/ Diabetes Mellitus, Type 2 - epidemiology
/ Diabetes Mellitus, Type 2 - metabolism
/ Dosage
/ Drug-Related Side Effects and Adverse Reactions - epidemiology
/ Efficacy
/ Female
/ Glucose
/ Groups
/ Hormones
/ Humans
/ Hyperprolactinemia - chemically induced
/ Hyperprolactinemia - epidemiology
/ Indexes
/ Intellectual Disability - drug therapy
/ Intellectual Disability - epidemiology
/ Intellectual Disability - metabolism
/ Intellectually disabled people
/ Lipids
/ Male
/ Mental Disorders - drug therapy
/ Mental Disorders - epidemiology
/ Mental Disorders - metabolism
/ Obesity
/ Safety
