© 2003 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Trends in the Rate and Type of Antipsychotic Medications Prescribed to Persons With Schizophrenia
Research Associate Professor, School of Social Work and Center for Mental Health Policy and Services Research, Department of Psychiatry, Medical Center, and Senior Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia, PA
Research Assistant Professor, Center for Mental Health Policy and Services Research, Department of Psychiatry, Medical Center, University of Pennsylvania
Adjunct Faculty, Department of Demography, School of Arts and Sciences, University of Pennsylvania
Send reprint requests to Aileen B. Rothbard, Research Associate Professor, Center for Mental Health Policy and Services Research, 3535 Market Street, Room 3014, Philadelphia, PA 19104-2648; e-mail: Rothbard{at}mail.med.upenn.edu
This article examines trends in antipsychotic medication use in a treated population of publicly funded patients with schizophrenia between 1991 and 1996. Findings from administrative claims data show that antipsychotic prescription rates increased from 79 percent to 83 percent between 1991 and 1996. Atypical antipsychotics were used by 39 percent of the population and comprised 41 percent of all antipsychotic agents prescribed compared to 59 percent for typical agents. Duration on a typical agent was 8 months versus 7.4 months for newer atypicals, with duration 11 months for those on clozapine. The highest switching behavior is found in users of atypicals (58% versus 25% for those on typicals) as is the percent of those who received an antidepressant concurrently with an antipsychotic, which was 44 percent for newer atypical users versus 31 percent for typical users. The lowest antidepressant use was among clozapine users (28%). Atypical users were more likely to be younger Caucasian men with higher use of inpatient and ambulatory mental health services compared to those on typical medications. The newer antipsychotic medications appear to be displacing traditional medications; however, contrary to what the literature suggests, duration is shorter and switching behavior and concurrent use of antidepressants is higher than in typical users.
Keywords: Schizophrenia / antipsychotic medication / atypicals / clozapine
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