{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:17:52Z","timestamp":1789417072064,"version":"build-2803163510"},"reference-count":40,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["218497\/Z\/19\/Z"],"award-info":[{"award-number":["218497\/Z\/19\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec id=\"S0007125024001867_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contemporary data relating to antipsychotic prescribing in UK primary care for patients diagnosed with severe mental illness (SMI) are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125024001867_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe contemporary patterns of antipsychotic prescribing in UK primary care for patients diagnosed with SMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125024001867_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Cohort study of patients with an SMI diagnosis (i.e. schizophrenia, bipolar disorder, other non-organic psychoses) first recorded in primary care between 2000 and 2017 derived from Clinical Practice Research Datalink. Patients were considered exposed to antipsychotics if prescribed at least one antipsychotic in primary care between 2000 and 2019. We compared characteristics of patients prescribed and not prescribed antipsychotics; calculated annual prevalence rates for antipsychotic prescribing; and computed average daily antipsychotic doses stratified by patient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125024001867_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 309 378 patients first diagnosed with an SMI in primary care between 2000 and 2017, 212,618 (68.7%) were prescribed an antipsychotic between 2000 and 2019. Antipsychotic prescribing prevalence was 426 (95% CI, 420\u2013433) per 1000 patients in the year 2000, reaching a peak of 550 (547\u2013553) in 2016, decreasing to 470 (468\u2013473) in 2019. The proportion prescribed antipsychotics was higher among patients diagnosed with schizophrenia (81.0%) than with bipolar disorder (64.6%) and other non-organic psychoses (65.7%). Olanzapine, quetiapine, risperidone and aripiprazole accounted for 78.8% of all antipsychotic prescriptions. Higher mean olanzapine equivalent total daily doses were prescribed to patients with the following characteristics: schizophrenia diagnosis, ethnic minority status, male gender, younger age and greater relative deprivation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125024001867_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Antipsychotic prescribing is dominated by olanzapine, quetiapine, risperidone and aripiprazole. We identified potential disparities in both the receipt and prescribed doses of antipsychotics across subgroups. To inform efforts to optimise prescribing and ensure equity of care, further research is needed to understand why certain groups are prescribed higher doses and are more likely to be treated with long-acting injectable antipsychotics compared with others.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2024.186","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T02:00:47Z","timestamp":1734487247000},"page":"269-277","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":11,"title":["Prescribing of antipsychotics for people diagnosed with severe mental illness in UK primary care 2000\u20132019: 20-year investigation of who receives treatment, with which agents and at what doses"],"prefix":"10.1192","volume":"226","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8577-9380","authenticated-orcid":false,"given":"Alvin","family":"Richards-Belle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4241-938X","authenticated-orcid":false,"given":"Naomi","family":"Launders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3044-3713","authenticated-orcid":false,"given":"Sarah","family":"Hardoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8645-1942","authenticated-orcid":false,"given":"Kenneth K.C.","family":"Man","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Bramon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-1539","authenticated-orcid":false,"given":"David P.J.","family":"Osborn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2286-3862","authenticated-orcid":false,"given":"Joseph F.","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"S0007125024001867_ref35","volume-title":"Psychosis and Schizophrenia in Adults: Prevention and Management","year":"2014"},{"key":"S0007125024001867_ref2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717000873"},{"key":"S0007125024001867_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmq014"},{"key":"S0007125024001867_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30416-X"},{"key":"S0007125024001867_ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053943"},{"key":"S0007125024001867_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(22)00225-5"},{"key":"S0007125024001867_ref4","doi-asserted-by":"publisher","DOI":"10.3109\/09540261.2011.606801"},{"key":"S0007125024001867_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5318"},{"key":"S0007125024001867_ref26","unstructured":"26 Brown, E , Shah, P , Kim, J . chlorpromazineR: Convert Antipsychotic Doses to Chlorpromazine Equivalents. rOpenSc, 2024 (https:\/\/docs.ropensci.org\/chlorpromazineR\/)."},{"key":"S0007125024001867_ref29","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21089"},{"key":"S0007125024001867_ref33","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-013-3154-1"},{"key":"S0007125024001867_ref34","doi-asserted-by":"publisher","DOI":"10.1383\/psyt.2005.4.10.11"},{"key":"S0007125024001867_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(22)00404-7"},{"key":"S0007125024001867_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31135-3"},{"key":"S0007125024001867_ref36","volume-title":"NICE Clinical Guideline 38. 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}