Ethnicity and Prescription Patterns for Haloperidol, Risperidone, and Olanzapine

Abstract

When other factors were controlled for, African Americans were significantly less likely to receive the newer antipsychotics. Among those who received the newer antipsychotics, ethnicity did not affect medication choice.

Length of Stay, Admission Types, Psychiatric Diagnoses, and the Implications of Stigma in African Americans in the Nationwide Inpatient Sample

“…DHHS, 1999), medication regimen (Copeland, Zeber, Valenstien, & Blow, 2003;Kuno & Robard, 2002;Opolka et al, 2004), and overall treatment participation and compliance (Sirey et al, 2001b). The stigmatized individual often withdraws from interactions with the public for fear of rejection and discrimination; as a result, he or she suffers from social isolation that can affect productivity and quality of life.…”

“…Symptoms often attributed to schizophrenia in AAs may actually reflect anxiety and depressive disorders. Misdiagnosis occurs when clinicians who are culturally incompetent automatically classify hallucinations in AAs as a definitive symptom of a diagnosis of schizophrenia rather than considering that hallucinations can occur in depressive disorders as well (Baker & Bell, 1999;Minsky et al, 2003;Neighbors et al, 2003;Opolka, Rascati, Brown, & Gibson, 2004;Snowden, 2001). Hallucinations are present in both major depression with psychotic features and schizophrenia as well as other conditions.…”

“…AAs are more likely to be prescribed first generation antipsychotics such as haloperidol rather than newer atypical antipsychotics such as risperidone (Copeland et al, 2003;Kuno & Rothbard, 2002;Opolka, Rascati, Brown, & Gibson, 2004;U.S. DHHS, 1999).…”

“…Some clinicians may perceive the psychotic symptoms as more severe for AAs and believe they can only be controlled with the older conventional antipsychotics, which cause more severe side effects compared to new atypical antipsychotics. Discrimination is cited as a factor in unfair prescribing practices (Kuno & Robard, 2002;Opolka et al, 2004). The gaps in prescribing practices are attributed to the financial status of AAs; for example, AAs who received uncompensated care were reported to receive more first generation antipsychotics (Herbeck et al, 2004).…”

The Delivery System Design of a Community Mental Health Center and Provision of Quality: Cardiometabolic Screening for Persons with a Severe Mental Illness Prescribed Atypical Antipsychotic Medication

“…African Americans received AA medications at 49% of the visits as compared to Whites who received an AA medication 66% of the time (Herbeck et al, 2004). A study of Texas Medicaid claims also found that African Americans were less likely to receive a prescription for an AA compared to whites (Opolka, Rascati, Brown, & Gibson, 2004). These studies used data from the late 1990s and early 2000s, at which time fewer AA medications were on the market, which might explain some disparities in prescribing.…”