Second-generation ("atypical") antipsychotics have become the treatment of choice for persons with schizophrenia and other serious mental illnesses. Compared to first generation ("conventional") antipsychotics, many second generation medications reduce symptoms with fewer problematic side-effects (with the exception of clozapine, which can have life-threatening side effects if not monitored regularly) and related major health problems (e.g., obesity, diabetes, and hyperlipidemia). Introduction of atypical antipsychotics has impacted 1) prescribing patterns across physician specialties, 2) type of drug prescribed (i.e., first or second generation antipsychotics) based on case-mix factors, such as age, race, and type of insurance coverage and 3) medication and/or total treatment costs. It has also facilitated significant discussion of the therapeutic value of "polypharmacy," meaning, the simultaneous prescription of more than one antipsychotic medication to a single patient. However, one aspect that has seen little empirical attention is how longitudinal trends, benefits, and costs may differ between urban and rural areas.

Publications

• Differences in Prescribing Patterns of Psychotropic Medication for Children and Adolescents Between Rural and Urban Prescribers
  WICHE Center for Rural Mental Health Research
  Date: 10/2009
  This study reports that prescriptions of all psychotropic drug categories increased for urban and rural populations during the 10-year study period. Urban youth were more likely to be prescribed psychotropic medications by psychiatrists. In contrast, rural youth were more likely to have psychotropics prescribed by generalists or other prescribers.