Longitudinal Racial/Ethnic Disparities in Antimanic Medication Use in Bipolar-I Disorder

This article examines racial and ethnic disparities in treatment for patients with bipolar-I disorder. Low-income, minority bipolar patients face significant hurdles navigating the health care system and in particular may have difficulty receiving second-generation antipsychotic medications.

The authors analyzed data collected by the Florida Medicaid program between 1997 and 2005, including enrollee claims for inpatient and outpatient visits and prescriptions. Their sample included 13,497 adults between age 18 and 64 with bipolar-I disorder.

Key Findings:

  • Across all races, antimanic medication use was low. At no point in the study did more than 60 percent of individuals qualified for medication fill their prescriptions.
  • Black individuals were 40-50 percent less likely to fill an antimanic prescription than White individuals. Black individuals were less likely to use mood stabilizers than White individuals, but equally likely to use antipsychotic monotherapy.
  • There was no disparities between Hispanic and White individuals in their use of antipsychotic medication. This is not consistent with prior research.
  • There was no change in disparities in medication use by White and Black individuals over the time period studied, 1997 through 2005.

This data suggests that significant disparities exist between White and Black patients in their use of antimanic medications for bipolar disease. The level of disparity does not appear to have changed significantly over the study period. No disparity was found in medication use between Hispanic and White individuals, although the Hispanic population grew rapidly in Florida over the duration of the study.