OBJECTIVE: To determine how deficit syndrome relates to patterns of antipsychotic drug use among persons with schizophrenia receiving community-based care. METHODS: Study participants were enrolled in the U.S. Schizophrenia Care and Assessment Program (SCAP). Data were obtained from participants who completed the baseline and 6-month assessments and were using antipsychotic medications at baseline (n=1019). Presence of deficit syndrome was assigned based on proxy methods using clinical data (Kirkpatrick B., et al., 1989). Antipsychotics were categorized as first-generation, second-generation, or other. Few participants received antipsychotics in the ‘other’ category (2%) and were not included in these analyses. Baseline characteristics and the presence of deficit syndrome were used to predict two outcomes: (1) the likelihood of receiving first-generation antipsychotics at the initial assessment, and (2) the likelihood of switching from one antipsychotic class to another between assessments. Covariates included demographic (gender, race, age, marital status, education, insurance), clinical (GAF, hallucinations/delusions, disorganization), medication adherence, and site variables. Logistic regression was applied. RESULTS: Deficit syndrome was not significantly related to use of a 1st-generation agent at baseline. A positive association was found for African Americans (.0004), lower hallucination/delusion scores (.02), and several site indicators (<.05) ( Orlando, Denver, Baltimore, and San Diego). The probability of switching antipsychotic classes between assessments was significantly related to one site indicator (.01) (Orlando); weak evidence (.08) of lower GAF scores being associated with a switch was observed. The presence of deficit syndrome did not achieve significance in either model. CONCLUSIONS: The deficit syndrome has been studied extensively in its relation to neurological function and course of illness. In the SCAP population of patients receiving community-based care at diverse settings, we do not find a relation between deficit syndrome and two measures of antipsychotic drug assignment. Further research may include evaluation of the relationship between deficit syndrome and drug assignment patterns over time.