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Changes in prevalence and patterns of antipsychotic prescribing among two nationally representative cohorts of adults with intellectual disabilities aged 40-49 years over a 10-year period

Widespread, and sometimes inappropriate use of antipsychotics in adults with intellectual disability has been the subject of international concern. These medicines have been used to treat mental health conditions in adults with intellectual disabilities, but also controversially behaviours in the absence of a mental health diagnosis. When used appropriately in diagnosed mental health conditions antipsychotics have an important role but inappropriate use carries significant risk of harm.
The IDS-TILDA study in the Trinity Centre for Ageing and Intellectual Disability is a large long-term study of adults with intellectual disability over 40 years of age which follows health and medication use of people with intellectual disability. Findings have highlighted that over four in ten older adults with intellectual disability took antipsychotics in the first two waves of the study(2009/2010 and 2013/2014) but only one-quarter reported a psychotic disorder. Those living in residential settings and community group homes were more likely to report antipsychotics compared to those who lived independently/with family. There was a high prevalence of older antipsychotics that carry more side effects. Wave 4 of the study took place in 2020 and new participants aged 40-49 years were recruited. In the past ten years changes in regulation, policy and prescribing practices in Ireland have focused on improving prescribing of these medicine. The aim of this study is to explore the changes in prevalence and patterns of antipsychotic use among adults with intellectual disability aged 40-49 years in 2009/2010 compared to the new cohort of 40-49 years olds in 2020.