Movement Disorders in Adults With Intellectual Disability and Behavioral Problems Associated With Use of Antipsychotics.
BACKGROUND
Antipsychotic drugs are prescribed to approximately 30% to 40% of adults with intellectual disability (ID) and behavioral problems despite lack of evidence of effectiveness and potential adverse effects, including movement disorders.


OBJECTIVE
The aim of this study was to examine the prevalence of movement disorders (dyskinesia, akathisia, dystonia, and parkinsonism) in in-patient adults with mild to borderline ID and behavioral problems associated with use of antipsychotics.


METHODS
Prevalence of movement disorders was measured with a standardized protocol. The strength of the association between antipsychotic drug use and movement disorders was assessed using logistic regression analysis.


RESULTS
Almost half (44.0%) of 134 in-patient adults with ID and behavioral problems had any movement disorder. Parkinsonism, dyskinesia, akathisia, and dystonia were present in, respectively, 36.6%, 11.2%, 9.0%, and 0.7% of patients with ID. It appeared that current use of any antipsychotic drug (odds ratio, 3.0; 95% confidence interval, 1.0-8.4) and a dose in target range (odds ratio, 5.5; 95% confidence interval, 1.5-20.4) were significantly associated with the risk of having movement disorders.


CONCLUSIONS
The prevalence of movement disorders in people with ID and behavioral problems is high, especially in ID patients using antipsychotics. More attention is needed for these movement disorders and their potential impact.
From the *Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht; †Altrecht Institute for Mental Health Care, Den Dolder; ‡Licht-Zorg, Psychiatric Care, Maarssen; §Behavioural Science Institute, Faculty of Social Sciences, Radboud University Nijmegen, Nijmegen; ∥GGZ Centraal, Department Innova, Amersfoort; and ¶Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, the Netherlands.
Arlette
A
Scheifes
Sanne
S
Walraven
Joost Jan
JJ
Stolker
Henk L I
HL
Nijman
Diederik E
DE
Tenback
Toine C G
TC
Egberts
Eibert R
ER
Heerdink
D000293:Adolescent; D000328:Adult; D017109:Akathisia, Drug-Induced / Q000175:diagnosis* / Q000453:epidemiology; D014150:Antipsychotic Agents / Q000009:adverse effects*; D015897:Comorbidity; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis* / Q000453:epidemiology; D004421:Dystonia / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010302:Parkinson Disease, Secondary / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D000066553:Problem Behavior; D055815:Young Adult
D014150:Antipsychotic Agents