The essential and potentially inappropriate use of antipsychotics across income groups: an analysis of linked administrative data

Can J Psychiatry. 2012 Aug;57(8):488-95. doi: 10.1177/070674371205700807.


Objective: To examine the essential and potentially inappropriate use of antipsychotics across income groups.

Method: Linked health, pharmaceutical use, and income data from British Columbia were analyzed to examine antipsychotic use in 2 study cohorts. In the first cohort, the essential use of antipsychotics was assessed among adults who had a recorded diagnosis of schizophrenia in a 2-year period, 2004-2005. In the second cohort, potentially inappropriate use of antipsychotics was examined in people with no recorded diagnosis of schizophrenia or bipolar disorders in 2004-2005. The second cohort was also composed exclusively of seniors with a dementia-related diagnosis who are either in long-term care or living in the community. Income-related differences in antipsychotic use in these 2 cohorts were assessed using logistic regression, controlling for health and sociodemographic characteristics known to influence medicine use.

Results: Among adults, the prevalence of essential antipsychotic use was high (85%), with higher odds of use evident among those in the middle-income group. Among seniors, the prevalence of potentially inappropriate antipsychotic treatment is 23%, with prevalence higher in long-term care (56%) than in the community (13%). No income-related differences were found in long-term care; however, in the community, higher odds of use were found in low-income seniors.

Conclusion: People from low-income households have slightly lower levels of essential antipsychotic use and are more likely to receive potentially inappropriate antipsychotic treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / psychology
  • British Columbia
  • Cohort Studies
  • Data Collection
  • Dementia / diagnosis
  • Dementia / drug therapy
  • Dementia / psychology
  • Drug Therapy, Combination
  • Drug Utilization / statistics & numerical data
  • Female
  • Healthcare Disparities
  • Humans
  • Inappropriate Prescribing*
  • Income*
  • Male
  • Middle Aged
  • Poverty
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy*
  • Schizophrenic Psychology*
  • Young Adult


  • Antipsychotic Agents