title: Evolution of First-generation and Second-generation Antipsychotic Prescribing Patterns in Belgium Between 1997 and 2012: A Population-based Study.
abstract: BACKGROUND
  In recent decades, a substantial increase in prescriptions of antipsychotics has been reported in several countries. This increase in antipsychotic sales has been attributed to the success of second-generation antipsychotics.
  
  
  METHODS
  This national register-based study investigated the evolution of outpatient antipsychotic sales in Belgium between 1997 and 2012. The impact of the specialization of the prescriber and the demographic characteristics of both prescribing doctors and patients were examined. The study used data obtained from the Belgian National Institute for Health and Disability Insurance and IMS Health Belgium.
  
  
  RESULTS
  Over this 15-year period, antipsychotic sales increased by 122% in Belgium. This growth was mainly explained by a 3-fold increase in antipsychotic prescriptions by psychiatrists and neurologists. Overall, only 29.5% of prescriptions for antipsychotics were for psychotic disorders and only 26.2% of prescriptions for antipsychotics were for mood disorders, suggesting a large amount of off-label use. A significant shift toward second-generation agents was found in prescriptions by both psychiatrists and general practitioners, although there may have been a small delay in moving toward second-generation agents in the latter group. This increase in second-generation antipsychotic prescribing was mainly due to the steep rise in sales of quetiapine, followed by olanzapine and risperidone. The shift toward the newer products was also mainly seen in younger prescribers.
  
  
  CONCLUSIONS
  The results of this study suggest that there has been an increase in adequate management of patients in need of antipsychotic treatment. Nevertheless, very few of the patients received continued treatment throughout the year, which implies that few outpatients with schizophrenia are receiving adequate treatment.
authors.affiliation: MORRENS, DESTOOP, CLEYMANS, VAN DER SPEK, and DOM: Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium MORRENS, DESTOOP, and DOM: Psychiatric Center Brothers Alexians, Boechout, Belgium.
authors.forename: Manuel
authors.initials: M
authors.lastname: Morrens
authors.forename: Marianne
authors.initials: M
authors.lastname: Destoop
authors.forename: Stijn
authors.initials: S
authors.lastname: Cleymans
authors.forename: Susan
authors.initials: S
authors.lastname: VAN DER Spek
authors.forename: Geert
authors.initials: G
authors.lastname: Dom
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data / Q000639:trends; D014150:Antipsychotic Agents / Q000145:classification / Q000627:therapeutic use; D001530:Belgium / Q000453:epidemiology; D062313:Databases, Pharmaceutical / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000706:statistics & numerical data / Q000639:trends; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents