IngentaConnect U.S. National Trends in the Use of Antipsychotics During Office V...

Authors: Aparasu, Rajender¹; Bhatara, Vinod²; Gupta, Sanjay³

Source: Annals of Clinical Psychiatry (after Jan 1, 2004), Volume 17, Number 3, Number 3/July-September 2005 , pp. 147-152(6)

Publisher: Taylor and Francis Ltd

Abstract:

Background . There is a paucity of studies on U.S. national trends in the use of antipsychotic medications in the 21st century. This study examined national trends in the prescribing of antipsychotic drugs in office-based physician practices. Methods . National probability sample survey data from 1998–2002 National Ambulatory Medical Surveys were used to analyze the prescribing trends. The weighted visit estimates and percentages were compared across the years using z-test. Results . The number of antipsychotic-related visits was found to increase significantly and nearly two-fold, from 4.6 million in 1998 to 8.6 million in 2002. During the same period, the number of visits for second-generation antipsychotic drugs nearly tripled. The proportion of visits for the second-generation agents, as a percentage of visits for all antipsychotic drugs, rose sharply from about 48% in 1998 to 84% in 2002. Correspondingly, the percentage of visits involving first-generation antipsychotic drugs declined. The growth in the number of visits involving antipsychotic drugs over the 5-year period was substantial (120%) in visits with non-psychiatrist physicians, but not in visits involving psychiatrists. Conclusions . The trend of growth in prescription of antipsychotic drugs in office visits, accounted by increased use of second-generation antipsychotics, has persisted into the 21st century. Increased prescribing of these agents by non-psychiatrists is also apparently fueling this trend. This trend of shift from first-to-second generation antipsychotic agents, though not unambiguously supported by extant safety and efficacy data, is endorsed by guidelines based on expert-consensus and limited data. Given the high-level use of second-generation drugs, more practical studies of these drugs, focusing on effectiveness or long-term outcomes, are needed.

Keywords: Antipsychotic; Trends; Office; Prescribing; Physicians

Document Type: Research article

DOI: 10.1080/10401230591002084

Affiliations: 1: Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, USA 2: University of South Dakota, School of Medicine, Sioux Falls, SD, USA 3: Olean General Hospital, Olean, NY, USA

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U.S. National Trends in the Use of Antipsychotics During Office Visits, 1998–2002