University of Groningen
Off-label use of antipsychotic medication in people with intellectual disabilities
Ramerman, Lotte
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2019
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Ramerman, L. (2019). Off-label use of antipsychotic medication in people with intellectual disabilities:
adherence to guidelines, long-term effectiveness, and effects on quality of life. Rijksuniversiteit Groningen.
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Off-label use of antipsychotic
medication in people with
intellectual disabilities
Adherence to guidelines, long-term effectiveness, and effects on quality of life
Lotte Ramerman
The research in this thesis has been performed at the Centre for Intellectual Disabilities and Mental Health, GGZ Drenthe, Assen and at the University Medical Center Groningen, depart-ment of child- and adolescent psychiatry, Groningen.
These studies were financed by ZonMW (Grant No. 836021020) and Stichting Zorgondersteun-ingsfonds.
ISBN (print): 978-94-034-1490-4 ISBN (digital): 978-94-034-1489-8
© Lotte Ramerman, 2019
All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means without the prior written permission of the author.
Cover design by Stijn van Swetselaar
Lay-out by Eduard Boxem, persoonlijkproefschrift.nl Printed by Ridderprint BV | www.ridderprint.nl
Off-label use of antipsychotic
medication in people with
intellectual disabilities
Adherence to guidelines, long-term effectiveness, and effects on quality of life
Proefschrift
ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen
op gezag van de
rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties.
De openbare verdediging zal plaatsvinden op maandag 15 april 2019 om 14.30 uur
door
Lotte Ramerman
geboren op 6 november 1987 te Borger
Promotor
Prof. dr. P.J. HoekstraCopromotor
Dr. G.M. de KuijperBeoordelingscommissie
Prof. dr. P.J.C.M. Embregts Prof. dr. R. Bruggeman Prof. dr. A.A.J. van der PuttenContent
Chapter 1 General introduction 7
Chapter 2 Adherence of clinicians to guidelines for the prescription of antipsychotic drugs to people with intellectual disabilities
23 Chapter 3 Exploring barriers and facilitators in the implementation and use of
guideline recommendations on antipsychotic drug prescriptions for people with intellectual disability
41
Chapter 4 Health-related quality of life in people with intellectual disability who use long-term antipsychotic drugs for challenging behaviour
63 Chapter 5 Changes in health-related quality of life in people with intellectual
disabilities who discontinue long-term used antipsychotic drugs for challenging behaviours
83
Chapter 6 Is risperidone effective in reducing challenging behaviours in individuals with intellectual disabilities after one year or longer use? A placebo-controlled, randomised, double-blind discontinuation study
101
Chapter 7 General discussion and conclusions 121
Chapter 8 Summary 131
Chapter 9 Samenvatting 139
Dankwoord 146
