The study population consisted of 3,750 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, and 10.7 percent were prescribed atypical antipsychotic agents. Black males and females were prescribed atypical antipsychotic agents less frequently than their counterparts. These findings indicate that atypical antipsychotic agents, which have proven effective in treating psychotic patients who have either not responded well or who experienced intolerable side effects to typical antipsychotics, are being used increasingly as the first line of pharmacotherapy. The introduction of atypical antipsychotics has provided an improved but more expensive tool for managing schizophrenia, and thus has prompted some debate about how best to spend scarce resources in the treatment of patients with psychotic disorders. Some argue that the advantages of the newer drugs, including tolerability, adherence to treatment, longer remission of symptoms, and fewer hospitalizations, may offset the initial costs of the medication. It will be important for future studies to track antipsychotic prescribing practices in inmate populations and to explore the driving forces behind these patterns. 4 tables and 19 references
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