Current Management of Schizophrenia: Antipsychotic Monotherapy versus Combination Therapy.

We investigated the current practice for treatment of schizophrenia. According to our data, 47 percent of patients with schizophrenia are treated with only antipsychotic medication. An additional 43 percent of patients receive one additional class to supplement their antipsychotic medication, and 10 percent of patients are prescribed two or more classes of drugs in addition to an antipsychotic medication.

Generic Penetration of the SSRI Market.

In this article, we investigate the penetration of generic selective serotonin reuptake inhibitors (SSRIs) in the US market and the implications for patient out-of-pocket expense. The data suggest that generic penetration into the SSRI market has grown from approximately nine percent in 2000, the year that the patent for Prozac((R)) expired, to 72 percent in 2007. For December, 2007, the difference in patient out-of-pocket expense for branded vs.

Treatment of fibromyalgia.

In this article, we investigate the range of treatments prescribed for fibromyalgia. The data suggest that the majority of those treated, 72 percent, receive only one pharmaceutical. An additional 18 percent of patients were prescribed two products and 10% received three products.

Treatment of autistic children.

In this article, we investigate the range of treatments prescribed to children with autism. The data suggest that approximately 58 percent of patients with a diagnosis of childhood autism receive some type of pharmaceutical treatment. The majority of those treated, 68 percent, receive only one pharmaceutical.

Use of antidepressants: expansion beyond depression and anxiety.

We investigated antidepressant prescriptions and reasons for use. According to our data, the top 10 molecules represent approximately 95% of total antidepressant prescriptions for both primary care physicians (PCPs) and psychiatrists. The primary difference between PCPs and psychiatrists was the increased use of buproprion and tricyclics/tetracyclics by psychiatrists.

Treatment of depression: antidepressant monotherapy and combination therapy.

We investigated the use of antidepressants in the treatment of depression. According to our data, antidepressants are most commonly used alone (85%); however, the prevalence of antidepressant monotherapy decreases as the physician's impression of patient severity increases (92% mild, 84% moderate, 73% severe). Psychiatrists are more likely to use antidepressant combinations than primary care physicians (32% vs.

Daytrana: the first year.

We investigated use of Daytrana in the first year post-launch in the US: May, 2006 through April, 2007. According to our data, a total of 512,085 prescriptions for Daytrana were written in the first year of launch; psychiatry accounted for 34 percent of these prescriptions. Children and adolescents represented 88 percent of Daytrana users as compared to only 57 percent for the broader ADHD market.

Current status of hypnotic prescribing habits in the United States.

Prescription data suggests that outside of primary care physicians, psychiatrists represent the second largest prescriber of sleep aids, accounting for 11 percent of total prescriptions. Use of individual agents do not differ between psychiatrists, primary care physicians, and neurologists.

Alzheimer's therapies.

This article investigates the role that psychiatrists play in the prescription of Alzheimer's disease therapies and the similarities and differences in treatment approach when compared to primary care physicians and neurologists. Psychiatrists account for 7.6 percent of new patient starts on Alzheimer's disease therapies.

Antipsychotic use varies by patient age.

Since their introduction in mid 1990's, atypical antipsychotics have been studied in a ever-expanding number of conditions. To gain a better understanding of current practice patterns, we investigated antipsychotic uses across different patient age groups. In both the 18 to 39 and 40 to 64 age groups, schizophrenia (ICD-9 295) and affective psychoses (ICD-9 296) account for approximately 70 percent of atypical antipsychotic use.

Emsam: the first year.

We investigated the use of EMSAM in the first year post-launch in the US-April of 2006 through March of 2007. According to our data, EMSAM represents <0.1 percent of total prescriptions for antidepressants in the US and is prescribed most often by psychiatrists (83%of prescriptions).

Use of Antipsychotics Pre- and Post-Dissemination of CATIE Data.

We investigated the share of branded and generic antipsychotics before and after the publication of the CATIE results in September, 2005. According to our data, the publication of the CATIE results has had very little impact on new patient starts. To determine the impact of CATIE on use of olanzapine (Zyprexa((R))) subsequent to first line therapy, we also examined product share for switch/add patients.

Strattera: ups, downs, and emerging uses.

Although overall prescribing of atomoxetine hydrochloride (HCI) (Strattera) continues to decline, recent anecdotal reports suggest emerging uses of the product in combination therapy. In this article we examine trends in atomoxetine (HCI) prescribing as well as use in combination with other psychotropic classes. An expert commentary is provided on the data.

Practice patterns and outcomes of percutaneous coronary interventions in the United States: 1995 to 1997.

Randomized trials have demonstrated the superiority of coronary stents in combination with a platelet-focused pharmacologic approach in percutaneous coronary intervention (PCI). However, nationally representative data examining the impact of these technologies on patient outcomes and costs remain scarce. This study sought to determine the real-world impact of changes in the use of stents and anticoagulant agents in PCI on outcomes and costs.