Contact: Communications@thenationalcouncil.org or 301-984-6200 x228

Recent survey results shed light on a new barrier to treatment affecting people with severe mental illness. The findings show fears raised by product liability litigation involving antipsychotic drugs may be putting patients with schizophrenia and bipolar disorder at risk for relapse. These fears add to the already heavy burden that patients face as they work to manage symptoms, stay on their medication and work with their treatment providers to improve their mental and physical health.

The survey was conducted among 402 psychiatrists who treat patients with schizophrenia and bipolar disorder.

Litigation Concerns May Jeopardize Antipsychotic Medication Adherence

According to surveyed psychiatrists, many patients are refusing to take an antipsychotic medication due to concerns about advertising related to product liability litigation.
• Almost all psychiatrists surveyed (93%) have had patients refuse to take an antipsychotic medication, with 48% of these refusals being fueled by fears about drugs involved in law suits.

Law firm advertisements have prompted patients doing well on their antipsychotic medications to stop taking the drugs or to reduce doses without consulting their psychiatrists first.
• Of the 389 psychiatrists (97%) who reported patients stopped taking medication or reduced their dosage, 52% believe their patients did so because of law firm advertisements. The majority of these psychiatrists (93%) reported that their patients took this potentially dangerous action without consulting them first.
• Of these psychiatrists, the majority (94%) reported patient relapse, with the most common consequences being:
o Symptom recurrence (93%)
o Hospitalization (75%)
o Loss of an important relationship (40%)
o Suicide attempt (26%)
o Loss of job (25%)
o Incarceration (21%)

Law firm advertisements about antipsychotic drugs have also prompted patients to ask their doctors to stop or switch their treatment.
• Of the 389 psychiatrists (97%) who reported this, 59% believe the patient requested the change due to concerns raised by law firm advertisements, even though the majority of psychiatrists (93%) reported that these patients were responding well to treatment.
• Of the patients who were doing well but requested a change, 71% of psychiatrists reported that they experienced a relapse, which most commonly led to the following:
o Symptom recurrence (92%)
o Hospitalization (68%)
o Loss of an important relationship (39%)
o Suicide attempt (26%)
o Loss of job (26%)
o Incarceration (17%)
• Half of the surveyed psychiatrists also reported that caregivers requested a medication switch or stop for their loved one due to similar concerns about law firm advertisements.

Psychiatrists May Alter Prescribing Practices Due to Liability Concerns

Over the last five years, psychiatrists who treat patients with schizophrenia or bipolar disorder have changed their prescribing practices due to product liability cases involving antipsychotic medications.
• More than half (55%) say they have altered their prescribing practices due to product liability cases, and 62% know colleagues who have taken the same actions.
• One-third (34%) of psychiatrists claim malpractice risk is an important consideration when deciding on a medication for their patients with schizophrenia or bipolar disorder.

Many psychiatrists (61%) reported frustration and concern that this type of litigation sometimes interferes with patient treatment.
• Thirty-one percent found patient resistance to starting medication due to concerns generated by law firm advertisements challenging, while 28% are concerned about malpractice risk if they prescribe a drug that’s the focus of product liability litigation.

Additional Challenges Faced When Selecting an Antipsychotic Medication

The findings from the survey are especially pertinent given the number of barriers that already exist in helping patients stay adherent to their treatment. The most challenging issues psychiatrists faced when deciding which antipsychotic medication to prescribe to their patients with schizophrenia and/or bipolar disorder were:
• Side effects (75%)
• Lack of adherence due to unwillingness to accept illness (73%)
• Medication costs (58%)
• Lack of adherence due to lack of support (50%)
• Co-occurring mental illnesses (49%)

When considering a medication for their patients, a drug that is well-tolerated by patients was cited as most important (93%), followed by side effect profile (89%), prior treatment experience (86%), promising efficacy data (84%) and previous personal experience with prescribing the medication (82%).

Survey Methodology

This research was conducted via a 20-minute online survey by WebSurveyResearch on behalf of Ipsos Insight Health. The survey was conducted among 402 psychiatrists sampled from WebSurveyResearch’s physician’s panel. All psychiatrists practice in the U.S. and treat patients with bipolar disorder and/or schizophrenia. Eighty percent of the psychiatrists have been practicing for more than 10 years. Interviews were conducted from March 5-12, 2007.

With a pure probability sample of 402 psychiatrists, one could say with a 95 percent probability that the overall results have a sampling error of +/- five percentage points. However, that does not take other sources of error into account. This online survey is not based on a probability sample and therefore no theoretical sampling error can be calculated.

This survey was conducted by independent market research company Ipsos-Insight and commissioned by the National Council for Community Behavioral Healthcare and Eli Lilly and Company. The survey was funded by Lilly.

Resources are available for clinicians who treat severe mental illness through the National Council at www.thenationalcouncil.org and Lilly at www.treatmentteam.com.

The National Council for Community Behavioral Healthcare is a not-for-profit 501(c)(3) association representing 1,300 mental health and addictions treatment and rehabilitation organizations that serve nearly six million adults, children, and families in communities across America.