Abstract
BackgroundGlobal 12-month psychosis prevalence is estimated at roughly 0.4%, although prevalence of antipsychotic use in the U.S. is estimated at roughly 1.7%. Antipsychotics are frequently prescribed for off label uses, but have also been shown to carry risk factors for certain comorbid conditions and with other prescription medications. The study aims to describe the socio-demographic and health characteristics of U.S. adults taking prescription antipsychotic medications, and to better understand the association of antipsychotic medications and comorbid chronic diseases.MethodsThe study pools 2013–2018 data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey of non-institutionalized U.S. residents (n = 17,691). Survey staff record prescription medications taken within the past 30 days for each respondent, from which typical and atypical antipsychotic medications were identified.ResultsPrevalence of antipsychotic use among U.S. adults was 1.6% (n = 320). Over 90% of individuals taking antipsychotics reported having health insurance and a usual place for care, significantly more than their counterparts not taking antipsychotics. Further, those taking antipsychotics reported higher prevalence of comorbid chronic diseases and took an average of 2.3 prescription medications more than individuals not taking antipsychotics. Individuals taking antipsychotics were more likely to sleep 9 or more hours per night, be a current smoker, and have a body mass index greater than 30 kg/m2.ConclusionsU.S. adults who take antipsychotic medications report more consistent health care access and higher prevalence of comorbid chronic diseases compared to those not taking antipsychotics. The higher comorbidity prevalence and number of total prescriptions highlight the need for careful assessment and monitoring of existing comorbidities and potential drug-drug interactions among adults taking antipsychotics in the U.S.
Highlights
Global 12-month psychosis prevalence is estimated at roughly 0.4%, prevalence of antipsychotic use in the U.S is estimated at roughly 1.7%
About 23% of individuals taking antipsychotic medications report a hospitalization in the past 12 months compared to roughly 10% in the rest of the population
The study provides a useful replication of past outpatient data estimates, while adding socio-demographic context on the use of antipsychotic medications in the general population [11]
Summary
Global 12-month psychosis prevalence is estimated at roughly 0.4%, prevalence of antipsychotic use in the U.S is estimated at roughly 1.7%. Antipsychotics are frequently prescribed for off label uses, but have been shown to carry risk factors for certain comorbid conditions and with other prescription medications. The study aims to describe the socio-demographic and health characteristics of U.S adults taking prescription antipsychotic medications, and to better understand the association of antipsychotic medications and comorbid chronic diseases. U.S depression prevalence has been estimated at approximately 20% using validated self-report questionnaires, but medication use is relevant, as the same study found over half of the 10% of U.S adults taking antidepressants reported no depressive symptoms [3]. Over two-thirds of adults with a mental disorder report at least one other comorbid health diagnosis, suggesting treatment of mental illness frequently requires careful consideration of concurrent pharmaceutical treatments [4]. Antipsychotics may be used for off-label treatments, and controlled trials have found benefits of atypical antipsychotics to treat dementia, insomnia, obsessivecompulsive disorder, generalized anxiety disorder and other conditions [9, 10]
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