Changing Patterns of Psychotropics Use Among Older Adults With Intellectual Disability Over a Decade, With a Focus on Designated Mental Health Conditions

Abstract

Background: Psychotropics (sometimes off-label), mental health diagnoses and behaviours of concern are common in older adults with intellectual disability. Guidelines recommend non-pharmacological interventions and regular medication review. This study examined changes in psychotropics among older adults (≥ 40) with intellectual disability. Methods: Longitudinal data were obtained from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) at two timepoints [Wave 1(2009/10); Wave 4(2019/20)]. Post hoc analysis, Chi-squared tests and univariate binary logistic regression were conducted. Results: Overall, psychotropics decreased (59.2% to 56.5%). Significant decreases in antipsychotics (43.1%–40.1%) and sedatives/hypnotics (13.6%–8.1%) and significant increase in antidepressants (26.2%–31.8%) were found. Nearly half of antidepressant users reported depression at Wave 1, compared with under 30% at Wave 4. Antipsychotics and antidepressants were common (75% and 60%, respectively) among those with behaviours of concern, after excluding clinical indications. Conclusion: Psychotropic prescribing remained consistent, though class-specific patterns shifted, with some decreases or increases observed.