Relationship between anti-seizure medication and behaviors that challenge in older persons with intellectual disability and epilepsy: a review

ORCID

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.

DOI

10.1080/14737175.2024.2393322

Publication Date

2024-08-19

Publication Title

Expert Review of Neurotherapeutics

Volume

24

Issue

11

ISSN

1473-7175

Embargo Period

2025-08-19

Keywords

Epilepsy, developmental disability, intellectual disability, older adults, seizures

First Page

1097

Last Page

1105

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