Trends in antipsychotic prescribing practices in an urban community mental health clinic.
OBJECTIVE
Availability of new psychotropic agents, and formulations, as well as expanded indications for previously available agents, has had an impact on prescribing patterns in community psychiatric practice. This study tracked changes in patient diagnostic profiles and compared antipsychotic prescribing patterns for patients managed by a continuing care team over a 2.25-year period.


METHODS
Data pertaining to patient diagnoses and psychotropic medications was obtained from sequential cross-sectional file review and the pharmacy database. Data were collected in late 2004 (n = 224) and early 2007 (n = 294).


RESULTS
The majority of patients suffered from DSM-IV schizophrenia, schizoaffective and related disorders (68% in 2004, 71% in 2007). Second generation antipsychotic (SGA) medications (79% in 2004, 99% in 2007 of all antipsychotics) were the most widely used agents. Use of quetiapine as a proportion of all oral SGAs increased (8% to 17%) as did that of long-acting risperidone (<1% to 17% of all antipsychotics) paralleled by a decline in long-acting first generation antipsychotic agents (15% to <1%). Significant changes in the prescription of non-benzodiazepine hypnotics and mood stabilizers were also noted.


CONCLUSIONS
Statistically significant changes in prescribing patterns of antipsychotics during the study period were noted. Likely causes are discussed.
Monshat
Kaveh
K
Department of Psychiatry, University of Melbourne, St Vincent's Hospital, Fitzroy, VIC, Australia. k.monshat@unimelb.edu.au
Carty
Bridget
B
Olver
James
J
Castle
David
D
Bosanac
Peter
P
D000284:Administration, Oral; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D019090:Case Management / Q000639:trends; D003155:Community Mental Health Centers / Q000706:statistics & numerical data / Q000639:trends*; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations; D003987:Dibenzothiazepines / Q000627:therapeutic use; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000069348:Quetiapine Fumarate; D012189:Retrospective Studies; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D014505:Urban Population; D014739:Victoria
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D003987:Dibenzothiazepines; D006993:Hypnotics and Sedatives; D000069348:Quetiapine Fumarate; D018967:Risperidone