Research Activities, February 2014

Primary care physicians slower to adopt new second-generation antipsychotic drugs than psychiatrists

Mental Health

Image: three pills. Overall, physicians waited at least 2 years after approval by the U.S. Food and Drug Administration to adopt second-generation antipsychotic drugs. However, adoption of the drugs was much faster among psychiatrists, according to a new study. 

Early research had indicated that second–generation antipsychotic drugs, although more costly than prior antipsychotics, were more efficacious and less likely to cause side effects, leading these drugs to become the first-line treatments for psychotic disorders. More recent research has questioned these conclusions, and thus the cost-effectiveness of using the newer drugs as first-line treatments. 

In the new study, Julie M. Donohue, Ph.D., of the University of Pittsburgh, and her colleagues found that the speed of drug adoption was slowest for the 80 percent of physicians who prescribed antipsychotic drugs who were primary care physicians (those in internal medicine, family practice, or pediatrics), somewhat faster for the 4 percent who were neurologists, and fastest for the 16 percent who were psychiatrists. Furthermore, physicians who prescribed a high volume of antipsychotic drugs adopted the second-generation drugs much faster than physicians who prescribed a low volume of such drugs. Finally, psychiatrists prescribed a greater variety of antipsychotic drugs than did primary care physicians, neurologists, or pediatricians (a median of six, two, and one different drug, respectively). 

The findings were based on data from a commercial database on the prescription of second-generation antipsychotic drugs by 30,369 physicians who prescribed any antipsychotic drug from January 1996 through September 2008. The study was funded in part by AHRQ (HS17695). 

More details are in "How quickly do physicians adopt new drugs? The case of second generation antipsychotics," by Haiden A. Huskamp, Ph.D., A. James O'Malley, Ph.D., Marcela Horvitz-Lennon, M.D., M.P.H., and others in the April 2013 Psychiatric Services 64(4), pp. 324-330.


Page last reviewed February 2014
Page originally created February 2014
Internet Citation: Primary care physicians slower to adopt new second-generation antipsychotic drugs than psychiatrists. Content last reviewed February 2014. Agency for Healthcare Research and Quality, Rockville, MD.