title: Adverse events and the relation with quality of life in adults with intellectual disability and challenging behaviour using psychotropic drugs.
abstract: BACKGROUND
  Psychotropic drugs are prescribed to approximately 30-40% of adults with intellectual disability (ID) and challenging behaviour, despite the limited evidence of effectiveness and the potential of adverse events.
  
  
  OBJECTIVE
  To assess the prevalence of adverse events in association with psychotropic drug use in adults with ID and challenging behaviour and to examine the relation of these adverse events with the person's quality of life.
  
  
  METHODS
  The presence of adverse events was measured with a questionnaire that had to be filled in by the physicians of the participants. Movement disorders were measured separately with a standardised protocol. The strength of the association between adverse events and Intellectual Disability Quality of Life-16 (IDQOL-16), and daily functioning was investigated using linear regression analyses, taking into account the severity of disease (CGI-S) as potential confounder.
  
  
  RESULTS
  Virtually all of 103 adults with ID and challenging behaviour had at least one adverse event (84.4%) and almost half had ≥3 adverse events (45.6%) across different subclasses. Using psychotropic drugs increased the prevalence of adverse events significantly. Respectively 13% of the patients without psychotropic drugs and 61% of the patients with ≥2 psychotropic drugs had ≥3 adverse events. Having adverse events had a significantly negative influence on the quality of life.
  
  
  CONCLUSIONS
  A large majority of all patients had at least one adverse event associated with psychotropic drug use. More attention is needed for these adverse events and their negative influence on the quality of life of these patients, taking into account the lack of evidence of effectiveness of psychotropic drugs for challenging behaviour.
authors.affiliation: Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, PO Box 80082, 3508 TB Utrecht, The Netherlands; Altrecht Aventurijn, Vuurvlinder 4, 3734 AB, Den Dolder, The Netherlands. Electronic address: a.scheifes@uu.nl.
authors.forename: Arlette
authors.initials: A
authors.lastname: Scheifes
authors.affiliation: Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, PO Box 80082, 3508 TB Utrecht, The Netherlands. Electronic address: s.walraven@students.uu.nl.
authors.forename: Sanne
authors.initials: S
authors.lastname: Walraven
authors.affiliation: Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, PO Box 80082, 3508 TB Utrecht, The Netherlands; Licht-Zorg, psychiatric care, De Hoopkade 22, 3604 DZ Maarssen, The Netherlands. Electronic address: joostjan.stolker@gmail.com.
authors.forename: Joost Jan
authors.initials: JJ
authors.lastname: Stolker
authors.affiliation: Altrecht Aventurijn, Vuurvlinder 4, 3734 AB, Den Dolder, The Netherlands; Behavioural Science Institute (BSI), Faculty of Social Sciences, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, The Netherlands. Electronic address: h.nijman@altrecht.nl.
authors.forename: Henk L I
authors.initials: HL
authors.lastname: Nijman
authors.affiliation: Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, PO Box 80082, 3508 TB Utrecht, The Netherlands; Department of Clinical Pharmacy, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: a.c.g.egberts@uu.nl.
authors.forename: Toine C G
authors.initials: TC
authors.lastname: Egberts
authors.affiliation: Department of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, PO Box 80082, 3508 TB Utrecht, The Netherlands; Altrecht Aventurijn, Vuurvlinder 4, 3734 AB, Den Dolder, The Netherlands; Department of Clinical Pharmacy, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: e.r.heerdink@uu.nl.
authors.forename: Eibert R
authors.initials: ER
authors.lastname: Heerdink
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects; D018692:Antimanic Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D001569:Benzodiazepines / Q000009:adverse effects; D000697:Central Nervous System Stimulants / Q000009:adverse effects; D015897:Comorbidity; D003430:Cross-Sectional Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D009426:Netherlands; D015995:Prevalence; D000066553:Problem Behavior / Q000523:psychology*; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D011619:Psychotropic Drugs / Q000009:adverse effects*; D011788:Quality of Life; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D011619:Psychotropic Drugs; D001569:Benzodiazepines
keywords: Adverse events; Challenging behaviour; Intellectual disability; Pharmacotherapy; Quality of life; Safety