Off-label utilization of antipsychotics

Details

Serval ID
serval:BIB_A3676EFD6441
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Off-label utilization of antipsychotics
Journal
South African Psychiatry Review
Author(s)
Zullino Daniele Fabio, Bilancioni Romain, Conus Philippe, Schwartz B., Khazaal Yasser, Baumann Pierre
ISSN
1811-7805
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
9
Number
1
Pages
38-43
Language
english
Notes
SAPHIRID:61693
Abstract
Objective: The newer atypical antipsychotics are prescribed because of their enhanced safety profiles and their larger pharmacological profile in comparison to the conventional antipsychotics. This has led to broad off-label utilisation. The aim of the present survey was to study the prescribing practice of hospital psychiatrists with regard to antipsychotic drugs, comparing patients treated for psychoses or other registered indications to patients receiving off-label antipsychotic treatment. Methods: As part of a pharmacovigilance/pharmacoepidemiology program, all drugs given on 5 reference days (1999-2001) in the 98-bed psychiatric hospital of the University of Lausanne, Switzerland, were recorded along with age, sex, and diagnosis. The prescriptions of 202 patients were assessed. Patients were classified in 3 diagnostic groups: (1) patient with psychotic disorders, (2) patients with manic episodes and depressive episodes with psychotic symptoms, and (3) patients with other disorders. Group (1) and (2) formed the class of patients receiving an antipsychotic for a registered indication, and the prescriptions in group (3) were considered as off-label. Results: A lesser number of psychotic patients received antidepressant (p < 0.05) and nonbenzodiazepine hypnotics (p < 0.001) compared to the patients of the other two groups. The patients with affective disorders seldom received a combination of an atypical and a conventional antipsychotic, whereas a lesser number of patients with off-label indications received atypical antipsychotics less often than those of the two comparison groups (p < 0.05). Stepwise logistic regression revealed that patients with a psychotic disorder were more likely to receive an antipsychotic medication in medium or high doses (p < 0.001), in comparison to the two other groups. Conclusion: The new antipsychotic drugs seem to be prescribed with less hesitation and mainly for approved indications. Physicians prescribed new drugs, off-label, only after having gained some experience in the field of the approved indications, and were more cautious with regard to doses when treating on an off-label basis. (PsycINFO Database Record (c) 2006 APA, all rights reserved) (journal abstract)
Create date
10/03/2008 11:38
Last modification date
20/08/2019 16:09
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