Efficacy and safety of antipsychotic treatments in people with intellectual disability and schizophrenia: updated systematic review and cross-sectional study ; Efficacité et tolérance des traitements antipsychotiques chez les personnes avec trouble du développement intellectuel et schizophrénie : revue systématique actualisée et étude transversale

Objectives: To determine the efficacy of antipsychotic medication for treating individuals with a dual diagnosis of intellectual disability (ID) and schizophrenia. Methods: We systematically reviewed the literature to explore the risks and benefits of antipsychotics for schizophrenia in ID. In addition, a cross-sectional retrospective study on the tolerance profiles of a representative ID and schizophrenia cohort was conducted. Results: From the systematic search, we retained 18 articles detailing information on 24 cases. In almost all cases, the antipsychotic improved positive symptoms. Negative manifestations were also improved, as were challenging behaviors. The most commonly reported side effects were neurological and metabolic manifestations. In the retrospective cross-sectional study, we reported data on 112 participants with comorbid ID and schizophrenia. 103 participants were antipsychotic-treated, of which 39% were on antipsychotic monotherapy. Of these, 35% were in the obesity range, 25% in the hyperglycemic range, and 25% in the dyslipidemia range. The Body Mass Index did not differ between the groups. Conclusions: This study provides an initial evidence base underpinning the efficacy of antipsychotic drugs on schizophrenia in the ID population. Nevertheless, there may be an increased risk of metabolic side effects, hence, close monitoring of blood glucose, lipids, and weight should be implemented when prescribing antipsychotics to this population. ; La schizophrénie est un trouble psychiatrique sévère qui débute généralement en fin d’adolescence et début d’âge adulte dont l’hypothèse physiopathologique actuelle retient des mécanismes complexes avec une interaction entre vulnérabilité génétique et expositions environnementales, orientant vers un stade final d’un trouble développemental. Dans cette perspective, la schizophrénie est souvent associée à des troubles du neurodéveloppement, notamment le trouble du développement intellectuel, d’autant plus que le début est précoce. On sait de plus, que le ...