Physician specialty associated with antipsychotic prescribing for youths in the Texas Medicaid program

The use of antipsychotics in children and adolescents in the Texas Medicaid program has increased with the introduction of newer atypical antipsychotics. The purpose of this study was to examine physician specialty associated with antipsychotic prescribing from 1996 to 2001.

All antipsychotic prescription claims records for children and adolescents younger than the age of 20 years from 1996 to 2001 were extracted from the Texas Medicaid Drug Vendor prescription database. Physician specialty associated with youths receiving all, atypical, and conventional antipsychotic prescriptions was examined for time trends. Physician specialty categories included psychiatry, primary care, neurology, other, and unspecified.

Psychiatrists accounted for more than 80% of youths receiving antipsychotic prescriptions from 1996 to 2001. The proportion of youths receiving antipsychotic prescriptions from primary care physicians remained fairly steady over the course of time (1996: 19%; 2001: 16%). The number of youths prescribed conventional antipsychotics decreased in all specialty groups, whereas the number prescribed atypical antipsychotic prescriptions increased dramatically.

Although the majority of children and adolescents in the Texas Medicaid program were prescribed antipsychotics by psychiatrists and child and adolescent psychiatrists, youths may often receive treatment within the primary care setting. Future research is necessary to evaluate patient outcomes associated with antipsychotic treatment across different treatment settings.