Trends in the Rate and Type of Antipsychotic Medications Prescribed to Persons With Schizophrenia

This article examines trends in antipsychotic medica-tion 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 popula-tion and comprised 41 percent of all antipsychotic agents prescribed compared to 59 percent for typical agents. Duration on a typical agent was 8 months ver-sus 7.4 months for newer atypicals, with duration 11 months for those on clozaplne. 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 clozaplne 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 med-ications appear to be displacing traditional medica-tions; however, contrary to what the literature sug-gests, duration is shorter and switching behavior and concurrent use of antidepressants is higher than in typical users