BRIEF RESEARCH REPORT article
Front. Psychiatry
Sec. Intellectual Disabilities
This article is part of the Research TopicEvidence for Assessing Drug Safety and Drug Use in Older People: Volume IIIView all 9 articles
The Overlooked Burden: Anti-Seizure Medications, Laxatives, and Antipsychotics in the Primary Care of People with Intellectual Disability
Provisionally accepted
- 1Cornwall Partnership NHS Foundation Trust, Bodmin, United Kingdom
- 2Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom
- 3Peninsula Medical School, Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, United Kingdom
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Objectives People with intellectual disabilities (PwID) have higher prevalence of epilepsy and constipation than general population. Constipation is having less than three bowel movements or receiving laxatives three or more times weekly. Both epilepsy and constipation contribute significantly to premature mortality. To manage constipation many are on long term laxatives. Laxatives thus are a surrogate indicator of constipation. PwID and epilepsy also have high prevalence of multi-morbidity and polypharmacy particularly involving anti-seizure medications (ASMs) and antipsychotics. The study aimed to explore associations between ASM, antipsychotics and laxative prescribing. Method The primary care dataset in Cornwall, England (population 572,000), patient prescribing records for laxatives, ASM and antipsychotics were examined using SNOMED diagnosis codes for PwID. Age and sex were identified. Results are reported as prevalence of study cohorts. Results Of 3189 PwID in Cornwall's GP registers, 2799 (88%) were over 18 and 1881 (59%) male. Of them, 725 (23%) were prescribed laxatives and 467 (15%) ASMs. Of these 209 were on both laxatives and ASMs (28.8% of all laxatives, 44.8% of all ASMs). Older PwID (> 40 years) were more likely to be on both ASM and laxatives. Of the 209, 72 (34.4%) were on antipsychotics over-represented by those over 40. Conclusion Nearly half of PwID on ASMs are prescribed laxatives and over a third of these were also found to be on antipsychotics. Given the significant links of epilepsy, constipation and anti-psychotics to premature mortality in PwID it is imperative that these be looked at as a group than individually.
Keywords: Antipsychotics, Constipation, developmental disorder, Epilepsy, Seizures
Received: 27 Sep 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Laugharne, Wilson, Wilcock and Shankar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rohit Shankar
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