Practical guidelines for the use of new generation antipsychotic drugs (except clozapine) in adult individuals with intellectual disabilities.
New generation antipsychotic (NGA) drugs introduced to the US market after clozapine (aripiprazole, olanzapine, paliperidone, quetiapine, risperidone, and ziprasidone) are frequently used in individuals with intellectual disabilities (ID). However, there is very limited research to fully establish evidence-based or personalized medicine approaches for their use in this population. These guidelines take a pragmatic approach to establishing frameworks for their use by utilizing the prescribing information and reviewing the available literature on other relevant neuropsychiatric disorders. In the absence of expert consensus guidance and well-controlled comparison trials, we present a set of guidelines to inform initiation, dosing and monitoring of use in adults. Further, in these guidelines we provide practical information on drug-drug interactions and adverse drug reactions, and a brief review of discontinuation syndromes, potential for abuse, use during pregnancy and cost considerations. We also provide drug utilization review forms for each NGA to facilitate implementation of these guidelines, these guidelines provide a practical and necessary resource for practitioners treating psychiatric disorders and challenging behaviors in adult individuals with ID.
de Leon
Jose
J
University of Kentucky Mental Health Research Center, Lexington, KY 40508, USA. jdeleon@uky.edu
Greenlee
Brian
B
Barber
Jack
J
Sabaawi
Mohamed
M
Singh
Nirbhay N
NN
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use; D004341:Drug Evaluation; D019317:Evidence-Based Medicine; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy; D019989:Persons with Intellectual Disabilities; D017410:Practice Guidelines as Topic; D011618:Psychotic Disorders / Q000188:drug therapy*
D014150:Antipsychotic Agents; D003024:Clozapine