Antipsychotic Prescriptions Rising Much Faster than Psychosis Rates

Priscilla Lynch 

February 04, 2021

While the rates of antipsychotic prescription in England doubled between 2007 and 2014, the odds of having psychotic symptoms rose only slightly over the same period, according to a new study published in  Schizophrenia Research.

The researchers used data from the nationally representative Adult Psychiatric Morbidity Surveys 2000, 2007 and 2014 of over 20,000 people to test whether the prevalence of psychotic symptoms increased between 2000 and 2014; compare prevalence of psychotic symptoms to the prevalence of being prescribed antipsychotic medication; and identify correlates of experiencing psychotic symptoms.

They found a small increase in the prevalence of psychotic symptoms in 2014 compared with 2000 (prevalence in 2000, 5.6%; 95% CI, 5.1%-6.2%; prevalence in 2014, 6.8%; 95% CI, 6.1%-7.6%).

This corresponded to an adjusted OR of 1.20 (95% CI, 1.02-1.40; P=.026) for experiencing psychotic symptoms in 2014 compared with 2007.

By comparison, antipsychotic medication use doubled over this period (prevalence in 2000, 0.6%; 95% CI, 0.4%-0.7%; prevalence in 2014, 1.2%; 95% CI, 0.9%-1.5%; aOR, 2.22; 95% CI, 1.52-3.25; P<.001).

The reasons for this warrant further investigation, said the study authors.

Lead study author Dr Natalie Shoham said: "The reasons for the disproportionate increase in antipsychotic medication use are difficult to explain. It might be because more people are being treated successfully for distressing symptoms, or that the medications are being used for other reasons, for example, to treat depression or as anti-sickness medications."

"These figures also may reflect an over-medicalisation of psychotic symptoms. Some people might be taking these medications for longer, or people with relatively minor symptoms might be more likely to be prescribed antipsychotics. Given the significant side effects of antipsychotics, it is important that prescriptions are reviewed regularly and that the impact of increased prescribing is carefully considered."

Shoham N, Cooper C, Lewis G, Bebbington P, McManus S. Temporal trends in psychotic symptoms: Repeated cross-sectional surveys of the population in England 2000-14. Schizophr Res. 2021;228:97-102. doi: 10.1016/j.schres.2020.11.057. PMID: 33434740 View abstract

This article originally appeared on Univadis, part of the Medscape Professional Network.

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