title: Pharmacological management of behavioral and psychiatric symptoms in older adults with intellectual disability.
abstract: Given medical and social advances, the life expectancy of individuals with intellectual disability (ID) has increased dramatically, leading to a generation of older individuals with such disabilities. This review focuses on the pharmacological treatment of behavioral and psychiatric symptoms and disorders in older adults with ID. Older adults with ID often present with medical co-morbidities and mental health issues. Medication management of behavioral and psychiatric problems is complicated by a higher risk for adverse events, lack of decision-making capacity, and complex care networks. Some studies have shown that individuals with ID and co-morbid mental disorders are undertreated in comparison with those with similar disorders in the general population, resulting in poorer outcomes. However, older adults with ID are also at risk of polypharmacy, and older age is a risk factor for development of side effects. A general principle is that medication treatment for psychiatric disorders in older individuals with ID should be started at low dosages and increased cautiously while monitoring response and side effects. The use of psychotropic drugs for older individuals with ID and behavioral problems remains controversial, particularly in those with dementia.
authors.affiliation: Central and North West London NHS Foundation Trust, Harrow Community Learning Disability Team, First Floor, 839 Honeypot Lane, Stanmore, MX, HA7 1AT, UK, nicole.eady@nhs.net.
authors.forename: Nicole
authors.initials: N
authors.lastname: Eady
authors.forename: Ken
authors.initials: K
authors.lastname: Courtenay
authors.forename: André
authors.initials: A
authors.lastname: Strydom
mesh_terms: D000368:Aged; D015897:Comorbidity; D003704:Dementia / Q000188:drug therapy*; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy*; D019338:Polypharmacy; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012307:Risk Factors
chemical_list: D011619:Psychotropic Drugs