Large Proportions of Patients Who Are Prescribed Antipsychotics in the U.K. Do Not Have Severe Mental Illnesses

Paul S. Mueller, MD, MPH, FACP

Instead, antipsychotics were prescribed for conditions such as anxiety, sleep disorders, and dementia.

Antipsychotic drugs are used to treat patients with severe mental illnesses, such as schizophrenia, other psychoses, and bipolar affective disorder. However, evidence suggests that these drugs are prescribed frequently for patients with anxiety, dementia, and sleep disorders. In this study, U.K. investigators used a primary care database to determine the indications for which antipsychotics were prescribed in 48,000 patients.

Fourteen thousand patients were prescribed first-generation antipsychotics (haloperidol, chlorpromazine, trifluoperazine), 28,000 were prescribed second-generation antipsychotics (olanzapine, quetiapine, risperidone), and 6,000 received prescriptions for both classes of drugs. Antipsychotic prescribing rates were higher in women than in men, in older adults (age, 80 vs. 40–49), and in people from the most-deprived versus the least-deprived areas. Of patients who were prescribed first-generation antipsychotics, only about 30% had severe mental illnesses; of those who were prescribed second-generation antipsychotics, 36% to 62% had severe mental illnesses. Common indications for antipsychotic prescribing in patients without severe mental illnesses were anxiety, depression, dementia, sleep disorders, and personality disorders; in these patients, antipsychotics generally were prescribed at lower doses and for shorter durations.

Citation(s):

Marston L et al. Prescribing of antipsychotics in UK primary care: A cohort study. BMJ Open 2014 Dec 18; 4:e006135.