Antipsychotic prescribing patterns in the Texas prison system

Although prison inmates are reported to exhibit elevated rates of psychotic disorders, little is known about antipsychotic pharmacotherapy in correctional settings. Therefore, the purpose of this study is to describe antipsychotic prescribing patterns in one of the nation's largest prison systems. The study population consisted of 3,750 Texas Department of Criminal Justice (TDCJ) inmates diagnosed with schizophrenic disorders, nonschizophrenic psychotic disorders, or both. In 1998, among inmates diagnosed with schizophrenic disorders, 14.6 percent were prescribed atypical antipsychotic agents, and 85.4 percent were prescribed typical antipsychotic agents. Among inmates diagnosed with nonschizophrenic psychotic disorders, 89.3 percent were prescribed typical antipsychotic agents, while 10.7 percent were prescribed atypical antipsychotic agents. Black males and females were prescribed atypical antipsychotic agents less frequently than their counterparts. Understanding such prescribing patterns is integral to the efficient and cost-effective planning of correctional mental health care.