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Morbidity and mortality of women and men with intellectual and developmental disabilities newly initiating antipsychotic drugs

Published online by Cambridge University Press:  02 January 2018

Simone N. Vigod*
Women's Mental Health Program, Women's College Hospital and Research Institute, Department of Psychiatry, University of Toronto, Ontario, Canada; The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
Yona Lunsky
The Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
Virginie Cobigo
The School of Psychology & Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, Ontario, Canada
Andrew S. Wilton
The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
Sarah Somerton
Women's Mental Health Program, Women's College Hospital and Research Institute, Toronto, Ontario, Canada
Dallas P. Seitz
Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Baycrest Health Sciences, Toronto, Ontario, Canada
Simone Vigod, Women's Mental Health Program, Women's College Hospital, 76 Grenville Street Room 7234, Toronto, Ontario M5S 1B2, Canada. Email:
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While up to 45% of individuals with intellectual and developmental disabilities (IDD) have a comorbid psychiatric disorder, and antipsychotics are commonly prescribed, gender differences in the safety of antipsychotics have rarely been studied in this population.


To compare men and women with IDD on medical outcomes after antipsychotic initiation.


Our population-based study in Ontario, Canada, compared 1457 women and 1951 men with IDD newly initiating antipsychotic medication on risk for diabetes mellitus, hypertension, venous thromboembolism, myocardial infarction, stroke and death, with up to 4 years of follow-up.


Women were older and more medically complex at baseline. Women had higher risks for venous thromboembolism (HR 1.72, 95% CI 1.15–2.59) and death (HR 1.46, 95% CI 1.02–2.10) in crude analyses; but only thromboembolism risk was greater for women after covariate adjustment (aHR 1.58, 95% CI 1.05–2.38).


Gender should be considered in decision-making around antipsychotic medications for individuals with IDD.

Research Article
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This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence (
Copyright © The Royal College of Psychiatrists 2016


Declaration of interest



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