Who Are Patients on Conventional Antipsychotics?

Abstract

The advent of atypical antipsychotics presented psychiatrists with an effective way of treating psychosis without the many side effects associated with conventional agents. Given the superiority of atypical antipsychotics, we examined demographic information and treatment histories of patients currently treated with conventional antipsychotics, especially in regard to treatment with atypical agents. Medication histories and demographic information for 276 patients admitted to an urban hospital were obtained by patient/family interviews and review of medical records. Chi-square and logistic regression tests were used to analyze data for possible predictive factors of which patients within the sample were still receiving conventional antipsychotics for treatment. Seventy-eight (28%) patients were currently being treated with conventional antipsychotics. More than half of them had never received a trial of an atypical agent. African-Americans, who are more likely to suffer adverse effects from conventional antipsychotics, and substance abusers were overrepresented in this group. It is unclear to what extent ethnic or cultural bias played a role in determining medication choice. Because conventional antipsychotics are associated with more side effects and greater medication nonadherence, these patients should be evaluated for appropriateness of a trial with an atypical agent even if they are currently stable with a conventional antipsychotic.

After the Black Box Warning: Predictors of Psychotropic Treatment Choices for Older Patients With Dementia

“…Higher use of first-generation antipsychotics among African-American patients compared with Caucasian patients has been previously documented (11,12). The only first-generation antipsychotic examined, haloperidol, was more likely than olazapine, quetiapine, or valproic acid to be prescribed among African-American patients (p=.009, p=.01, and p=.001, respectively, in post hoc tests).…”

Patterns of, and factors associated with, atypical and typical antipsychotic prescribing by general practitioners in the UK during the 1990s

“…Studies in the US have concluded that ethnic minority patients are less likely to be prescribed atypical antipsychotics relative to the general population (Opolka, Rascati, Brown, & Gibson, 2004;Valenti, Narendram, & Pristach, 2003). It may be the case that similar discrimination occurs against older schizophrenia and schizoaffective disorder patients.…”

Exploring the Impact of Race on Mental Health Service Utilization Among African Americans and Whites With Severe Mental Illness

“…They report generally consistent findings. With few exceptions, AAs in these samples have a lower likelihood of receiving atypical versus conventional antipsychotics (Copeland, Zeber, Valenstein, & Blow, 2003;Herbeck et al, 2004;Kreyenbuhl, Zito, Buchanan, Soeken, & Lehman, 2003;Mark, Palmer, Russo, & Vasey, 2003;Opolka, Rascati, Brown, Barner, et al, 2003;, 2004Valenti, Narendran, & Pristach, 2003); they receive significantly higher antipsychotic doses (Diaz & De Leon, 2002;dosReis, Zito, Buchanan, & Lehman, 2002;Valenstein et al, 2004); and they are more likely to receive diagnoses of schizophrenia versus affective disorders (Barnes, 2004;Butterfield et al, 2004;Mathews, Glidden, & Hargreaves, 2002;Neighbors, Trierweiler, Ford, & Muroff, 2003;Strakowski et al, 1996;Strakowski et al, 2003;Trierweiler et al, 2000). However, it is difficult to distinguish the specific influence of race on disparate outcomes from other factors that may characterize acute care samples.…”