{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:52:20Z","timestamp":1788871940540,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T00:00:00Z","timestamp":1390348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Baily Thomas Foundation, UK"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J intellect Disabil Res"],"published-print":{"date-parts":[[2015,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n A high proportion of adults with an intellectual disability (\n ID<\/jats:styled-content>\n ) are known to receive psychotropic medications for the management of aggressive behaviour in the absence of any psychiatric diagnosis. Despite this widespread use of psychotropic medication in general and antipsychotic medication in particular, no study has reported the trajectory of psychotropic medication use using a prospective design.\n <\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n \n We have prospectively studied a community, clinic\u2010based sample of 100 adults with\n ID<\/jats:styled-content>\n and aggressive behaviour over a 6\u2010month period for use of psychotropic medication in general and antipsychotics in particular, and compared them with demographic, psychiatric and behavioural variables.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Psychotropic medications were used for 89% of patients at baseline (\n T<\/jats:styled-content>\n 1) and 90% at 6 months' (\n T<\/jats:styled-content>\n 2) follow\u2010up. Risperidone was the most commonly used antipsychotic medication followed by chlorpromazine, haloperidol, olanzapine, zuclopenthixol and quetiapine. Other commonly used medications were\n SSRI<\/jats:styled-content>\n antidepressants such as citalopram, paroxetine and fluoxetine followed by mood stabilisers such as carbamazepine and sodium valproate. Although in a high proportion of cases carbamazepine and sodium valproate were used to treat epilepsy\n per se<\/jats:italic>\n . A high proportion (45%) received more than one (polypharmacy) psychotropic medication at\n T<\/jats:styled-content>\n 1; however, this proportion decreased slightly to 41% at\n T<\/jats:styled-content>\n 2. As for antipsychotic prescribing specifically, a similar proportion received them at\n T<\/jats:styled-content>\n 1 (75%) and\n T<\/jats:styled-content>\n 2 (73%), with polypharmacy of antipsychotics remaining similar at\n T<\/jats:styled-content>\n 1 (10%) and at\n T<\/jats:styled-content>\n 2 (9%). Twenty\u2010three per\u2009cent and 20% of patients received over 300\u2009mg\/day of chlorpromazine equivalent dose of antipsychotics at\n T<\/jats:styled-content>\n 1 and\n T<\/jats:styled-content>\n 2 respectively. However, there was an overall significant reduction in the severity of aggressive behaviour between\n T<\/jats:styled-content>\n 1 and\n T<\/jats:styled-content>\n 2. Higher doses of antipsychotic prescribing were positively correlated with more severe aggressive behaviour, physical aggression towards objects, self\u2010injurious behaviour and increasing age. There was no significant association with other demographic variables, physical health conditions or psychiatric diagnosis. Neither was there any significant correlation between mean aggression severity score change and antipsychotic daily dose change between\n T<\/jats:styled-content>\n 1 and\n T<\/jats:styled-content>\n 2.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n To our knowledge, this is the first ever comprehensive follow\u2010up study of use of psychotropic medications in general but antipsychotics in particular over a 6\u2010month period in adults with\n ID<\/jats:styled-content>\n and aggressive behaviour, in a clinic\u2010based community setting which also compared the trajectory of severity of aggressive behaviour with that of antipsychotic medication dose. Our study shows that not only the use of psychotropic medication is common among adults with\n ID<\/jats:styled-content>\n who attend psychiatric clinics for aggressive behaviour, the use of polypharmacy of psychotropic medications in general and high dose of antipsychotics in particular are equally prevalent. However, in some cases two antipsychotics may have been prescribed simultaneously as the psychiatrist is in the process of switching from one to another.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jir.12119","type":"journal-article","created":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T20:37:27Z","timestamp":1390423047000},"page":"11-25","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":115,"title":["Characteristics and the trajectory of psychotropic medication use in general and antipsychotics in particular among adults with an intellectual disability who exhibit aggressive behaviour"],"prefix":"10.1111","volume":"59","author":[{"given":"S.","family":"Deb","sequence":"first","affiliation":[{"name":"Imperial College London Department of Medicine Division of Brain Sciences Charing Cross Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Unwin","sequence":"additional","affiliation":[{"name":"School of Psychology University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Deb","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.176.1.42"},{"key":"e_1_2_7_3_1","first-page":"159","article-title":"Treatment of psychiatric and behavioural problems in mental retardation","volume":"105","author":"Aman G.","year":"2000","journal-title":"American Journal on Mental Retardation"},{"key":"e_1_2_7_4_1","first-page":"283","article-title":"The Aberrant Behavior Checklist\u2010Community: factor validity and effect of subject variables for adults in group homes","volume":"100","author":"Aman M. 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