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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*
Affiliation:
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
Affiliation:
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
Affiliation:
The School of Psychology & Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, Ontario, Canada
Andrew S. Wilton
Affiliation:
The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
Sarah Somerton
Affiliation:
Women's Mental Health Program, Women's College Hospital and Research Institute, Toronto, Ontario, Canada
Dallas P. Seitz
Affiliation:
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: simone.vigod@wchospital.ca
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Abstract

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Background

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.

Aims

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

Method

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.

Results

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).

Conclusions

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

Type
Research Article
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Copyright
Copyright © The Royal College of Psychiatrists 2016

Footnotes

Declaration of interest

None.

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