U.S. national trends in the use of antipsychotics during office visits, 1998-2002.
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.
Aparasu
Rajender R
RR
Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD 57007, USA. rajender.aparasu@sdstate.edu
Bhatara
Vinod
V
Gupta
Sanjay
S
D014150:Antipsychotic Agents / Q000627:therapeutic use*; D017277:Drug Approval; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000639:trends; D006801:Humans; D011336:Probability; D012017:Referral and Consultation / Q000639:trends*; D014481:United States
D014150:Antipsychotic Agents