Abstract
Introduction: There is increased focus on the negative impact of the overprescribing of medication, specifically psychotropic medication, including anti-seizure medications (ASM), in people with Intellectual Disability (ID). This is particularly important for the older adult population, where multi-morbidity and polypharmacy are more common. ASMs are associated with psychiatric and behavioral adverse effects. Furthermore, there is growing awareness of the anticholinergic burden for older adults with epilepsy and ID and the relationship with behaviors that challenge (BtC). Areas covered: This review defines the older adult population and outlines the relationship between epilepsy and ID. BtC is outlined in the context of the population and the relationship with ASMs. The evidence base to guide prescribing and de-prescribing for newer ASMs is also presented, including pragmatic data. Expert opinion: Polypharmacy, particularly psychotropics, are a mortality risk factor for older adults with epilepsy and ID. Therefore, any BtC requires a holistic assessment with a multi-disciplinary approach. This includes specific consideration of all prescribed medicines in the context of polypharmacy. There should be routine reviews, at least annually, for those aged 40 years and over particularly focused on anticholinergic burden and/or polypharmacy.
Original language | English |
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Pages (from-to) | 1097-1105 |
Number of pages | 9 |
Journal | Expert Review of Neurotherapeutics |
Volume | 24 |
Issue number | 11 |
DOIs | |
Publication status | Published - 19 Aug 2024 |
ASJC Scopus subject areas
- General Neuroscience
- Neurology (clinical)
- Pharmacology (medical)
Keywords
- Epilepsy
- developmental disability
- intellectual disability
- older adults
- seizures