The metabolic adverse effects of antipsychotic use in individuals with intellectual and/or developmental disability: A systematic review and meta‐analysis.

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Title: The metabolic adverse effects of antipsychotic use in individuals with intellectual and/or developmental disability: A systematic review and meta‐analysis.
Authors: Smith, Emily (AUTHOR), Stogios, Nicolette (AUTHOR), Au, Emily (AUTHOR), Maksyutynska, Kateryna (AUTHOR), De, Riddhita (AUTHOR), Ji, Andrew (AUTHOR), Erlang Sørensen, Mikkel (AUTHOR), St. John, Laura (AUTHOR), Lin, Hsiang‐Yuan (AUTHOR), Desarkar, Pushpal (AUTHOR), Lunsky, Yona (AUTHOR), Remington, Gary (AUTHOR), Hahn, Margaret (AUTHOR), Agarwal, Sri Mahavir (AUTHOR)
Source: Acta Psychiatrica Scandinavica. Sep2022, Vol. 146 Issue 3, p201-214. 14p. 1 Diagram, 3 Graphs.
Subjects: Children with developmental disabilities, Developmental disabilities, People with disabilities, CINAHL database, Weight gain, Drug side effects
Abstract: Objective: Individuals with intellectual and/or developmental disability (IDD) are often prescribed antipsychotics (APs). However, despite their known propensity to cause metabolic adverse effects, including weight gain, diabetes, and increased risk of cardiovascular events, there is currently a limited body of literature describing the metabolic consequences of AP use in this population. Methods: We searched MEDLINE, EMBASE, PsychINFO, CENTRAL, and CINAHL databases to identify all randomized trials that reported on the metabolic effects of APs in individuals with IDD. Random effects meta‐analyses were used to examine weight gain as both a continuous and dichotomous outcome. Results: Eighteen randomized trials met our inclusion criteria with a total of 1376 patients across a variety of IDDs. AP use was associated with significantly greater weight gain compared with placebo (Continuous: mean difference = 1.10 kg, [0.79, 1.40], p < 0.00001, I2 = 54%; Dichotomous: odds ratio = 3.94, [2.15, 7.23], p < 0.00001, I2 = 0). Sub‐group analysis revealed no significant effect of AP type. Data regarding the effects of APs on other metabolic outcomes were limited. Conclusion: This review (PROSPERO # CRD42021255558) demonstrates that AP use is associated with significant weight gain among patients with IDD. Concerningly, most reported studies were in children and adolescents, which sets up an already vulnerable population for adverse medical sequalae at an early age. There was also a lack of long‐term studies in adults with IDD. Further studies are required to better understand how AP use affects metabolic parameters in this group of individuals. [ABSTRACT FROM AUTHOR]
Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The metabolic adverse effects of antipsychotic use in individuals with intellectual and/or developmental disability: A systematic review and meta‐analysis.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Acta+Psychiatrica+Scandinavica%22&quot;&gt;Acta Psychiatrica Scandinavica&lt;/searchLink&gt;. Sep2022, Vol. 146 Issue 3, p201-214. 14p. 1 Diagram, 3 Graphs.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Children+with+developmental+disabilities%22&quot;&gt;Children with developmental disabilities&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Developmental+disabilities%22&quot;&gt;Developmental disabilities&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22People+with+disabilities%22&quot;&gt;People with disabilities&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CINAHL+database%22&quot;&gt;CINAHL database&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Weight+gain%22&quot;&gt;Weight gain&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Drug+side+effects%22&quot;&gt;Drug side effects&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Individuals with intellectual and/or developmental disability (IDD) are often prescribed antipsychotics (APs). However, despite their known propensity to cause metabolic adverse effects, including weight gain, diabetes, and increased risk of cardiovascular events, there is currently a limited body of literature describing the metabolic consequences of AP use in this population. Methods: We searched MEDLINE, EMBASE, PsychINFO, CENTRAL, and CINAHL databases to identify all randomized trials that reported on the metabolic effects of APs in individuals with IDD. Random effects meta‐analyses were used to examine weight gain as both a continuous and dichotomous outcome. Results: Eighteen randomized trials met our inclusion criteria with a total of 1376 patients across a variety of IDDs. AP use was associated with significantly greater weight gain compared with placebo (Continuous: mean difference = 1.10 kg, [0.79, 1.40], p &lt; 0.00001, I2 = 54%; Dichotomous: odds ratio = 3.94, [2.15, 7.23], p &lt; 0.00001, I2 = 0). Sub‐group analysis revealed no significant effect of AP type. Data regarding the effects of APs on other metabolic outcomes were limited. Conclusion: This review (PROSPERO # CRD42021255558) demonstrates that AP use is associated with significant weight gain among patients with IDD. Concerningly, most reported studies were in children and adolescents, which sets up an already vulnerable population for adverse medical sequalae at an early age. There was also a lack of long‐term studies in adults with IDD. Further studies are required to better understand how AP use affects metabolic parameters in this group of individuals. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1111/acps.13484
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      – Code: eng
        Text: English
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        PageCount: 14
        StartPage: 201
    Subjects:
      – SubjectFull: Children with developmental disabilities
        Type: general
      – SubjectFull: Developmental disabilities
        Type: general
      – SubjectFull: People with disabilities
        Type: general
      – SubjectFull: CINAHL database
        Type: general
      – SubjectFull: Weight gain
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      – SubjectFull: Drug side effects
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              M: 09
              Text: Sep2022
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