Characteristics of U.S. adults taking prescription antipsychotic medications, National Health and Nutrition Examination Survey 2013-2018

Background: Global 12-month psychosis prevalence is estimated at roughly 0.4%, although prevalence of antipsychotic use in the U.S. is estimated at roughly 1.7%. Antipsychotics are frequently prescribed for off label uses, but have also been shown to carry risk factors for certain comorbid conditions and with other prescription medications. The study aims to describe the socio-demographic and health characteristics of U.S. adults taking prescription antipsychotic medications, and to better understand the association of antipsychotic medications and comorbid chronic diseases. Methods: The study pools 2013-2018 data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey of non-institutionalized U.S. residents (n = 17,691). Survey staff record prescription medications taken within the past 30 days for each respondent, from which typical and atypical antipsychotic medications were identified. Results: Prevalence of antipsychotic use among U.S. adults was 1.6% (n = 320). Over 90% of individuals taking antipsychotics reported having health insurance and a usual place for care, significantly more than their counterparts not taking antipsychotics. Further, those taking antipsychotics reported higher prevalence of comorbid chronic diseases and took an average of 2.3 prescription medications more than individuals not taking antipsychotics. Individuals taking antipsychotics were more likely to sleep 9 or more hours per night, be a current smoker, and have a body mass index greater than 30 kg/m2. Conclusions: U.S. adults who take antipsychotic medications report more consistent health care access and higher prevalence of comorbid chronic diseases compared to those not taking antipsychotics. The higher comorbidity prevalence and number of total prescriptions highlight the need for careful assessment and monitoring of existing comorbidities and potential drug-drug interactions among adults taking antipsychotics in the U.S.