scholarly journals Off-label prescribing by psychiatrists

2006 ◽  
Vol 30 (2) ◽  
pp. 55-57 ◽  
Author(s):  
Richard Hodgson ◽  
Ravindra Belgamwar
Keyword(s):  
One Health ◽  
Atypical Antipsychotics ◽  
Clinical Excellence ◽  
Prescribing Patterns ◽  
Best Interests ◽  
Off Label Use ◽  
Economic Implications ◽  
Off Label ◽  
Icd 10 ◽  
Label Use

Aims and MethodTo report on the use of atypical antipsychotics in one health district by examining secondary care prescribing patterns for these medicines in North Staffordshire between 1994 and 2001. With one exception, these drugs were licensed solely for use in schizophrenia during the study period.ResultsA total of 502 patients were initiated on atypical antipsychotics in the study period. Of these, 297 (59.2%) had a diagnosis of schizophrenia (ICD–10 codes F20–29). Off-label prescribing was common, but psychiatrists were least likely to prescribe clozapine off-label (2.2%). Affective (18.4%) and organic disorders (12.4%) were the main disorders treated off-label. Olanzapine had the highest off-label use (44.5%).Clinical ImplicationsThe high off-label use of atypical antipsychotics has clinical and economic implications. Although off-label prescribing may be in the patient's best interests, they should be informed and give their consent. Commissioning bodies, such as primary care organisations, are basing their budgets on guidance from the National Institute for Clinical Excellence, which can have implications for funding this off-label use.

scholarly journals Quetiapine: off-label prescribing in a community mental health team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S63-S64
Author(s):  
Ala Abdelgadir ◽  
Richard Walsh ◽  
Elizabeth Walsh ◽  
Sonn Patel
Keyword(s):  
Mental Health ◽  
Psychotic Disorders ◽  
Prescribing Patterns ◽  
Low Doses ◽  
Off Label Use ◽  
Mental Health Team ◽  
Off Label ◽  
Health Team ◽  
Icd 10 ◽  
Label Use

AimsQuetiapine is an atypical anti-psychotic medication licensed for the treatment of schizophrenia, bipolar disorder and adjunctive use in major depressive disorder. It's off-label use in low doses is increasing, possibly due to its sedative qualities, tolerability, low risk of extrapyramidal symptoms and to limit the unnecessary use of benzodiazepines. However, previous research highlights the risk of metabolic consequences even in low doses. Our aim is to establish the prescribing patterns and off-label use of quetiapine within a complete comminity mental health team population (CMHT).MethodThe GR1 CMHT provides care to a population of 25,000 people in a mixed urban and rural area. Multi-disciplinary case notes for all registered patients were reviewed for a one-year period. A database was created to include sociodemographic details, diagnosis, and medication. The proportion of patients prescribed quetiapine was identified and the dosage divided into multiple increments. The team's consultant reviewed and verified all ICD-10 diagnoses. Quetiapine dose by diagnosis was examined using descriptive statistics.ResultOf 246 registered patients, 62 (25% of CMHT caseload) were prescribed Quetiapine. Quetiapine was prescribed across a range of disorders including psychotic 17 (27%), mood 18 (29%), anxiety 14 (22 %), personality disorders 11 (18%) and others 2 (3%). Doses spanned between 25 mg – 800 mg daily. 19 patients (31%) were prescribed less than 25 mg, 20 patients (32%) between 25 mg and 100 mg and 23 patients (37%) above 100 mg. In psychotic and mood disorders, dosage varied widely between the low and high range. Furthermore, of the psychotic disorders, 11 (65%) were prescribed a second antipsychotic medication. For diagnoses in which the prescribing indication was clearly off-label, the dosages were predominantly low (100 mg or less).ConclusionQuetiapine was commonly prescribed in our patient population. Its frequent off-label use in low doses suggests that its prescription was for its additional qualities. Our findings highlight the importance of assessing the risk-benefit profile for every patient given the potential side effects, involving patients in the consultation of its off-label use and appropriate monitoring.

Off-Label Use of Atypical Antipsychotics

CNS Drugs ◽  
2012 ◽  
Vol 26 (5) ◽  
pp. 383-390 ◽  
Author(s):  
Andrew McKean ◽  
Erik Monasterio
Keyword(s):  
Atypical Antipsychotics ◽  
Off Label Use ◽  
Off Label ◽  
Label Use

Off-Label Drug Use in Pediatric Out-Patient Care: A Multi-Center Observational Study

2020 ◽  
pp. 001857872094222
Author(s):  
Aeshah AlAzmi ◽  
Zahra Alasmari ◽  
Consuela Yousef ◽  
Ahmed Alenazi ◽  
Mohammed AlOtaibi ◽  
...  
Keyword(s):  
Drug Use ◽  
Observational Study ◽  
Pediatric Population ◽  
Prescribing Patterns ◽  
Off Label Use ◽  
Kingdom Of Saudi Arabia ◽  
Off Label ◽  
High Incidence ◽  
Study Support ◽  
Label Use

Objective: Prescribing a drug for a child is not an easy task and requires using the best available evidence as a guide, especially when a drug is used off-label. The practice of prescribing a drug for off-label use is fairly widespread worldwide. The FDA does not regulate prescribing patterns or practices of individual practitioners and, therefore, allows off-label use. The main objective of this study is to evaluate off-label prescribing among the pediatric population in the Kingdom of Saudi Arabia (KSA). Method: This is a retrospective, simple random selection observational study of children (≤15 years) who visited pediatric clinics and had at least 1 drug prescribed over a 12-month period (January to December 2018). Results: A total of 865 drugs (mean 1 and SD 0.24) were prescribed to 326 children. Off-label was identified in 39.4% of the drugs with a frequency of 512 (as 1 drug may belong to more than 1 off-label category). The most common reason for off-label prescribing was related to doses that were “higher or lower than the recommended use” (48.6%), and the most frequently identified drug class prescribed for off-label use was anti-infective drugs for systemic use (39.9%). The percentage of off-label drug use was found to be higher in girls and in the age group of 1 month to 2 years ( P = .001) for both variables. In addition, a significant association was found between off label drug use and the total number of drugs prescribed, P < .001. Conclusion: The findings of this study showed a high incidence of off-label prescribing mainly related to dosing and indication. The results of this observational study support the need to establish a unified national pediatric dosing formulary guide to ensure safe drug use in pediatrics.

scholarly journals National trends in off-label use of atypical antipsychotics in children and adolescents in the United States

Medicine ◽  
2016 ◽  
Vol 95 (23) ◽  
pp. e3784 ◽  
Author(s):  
Minji Sohn ◽  
Daniela C. Moga ◽  
Karen Blumenschein ◽  
Jeffery Talbert
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Atypical Antipsychotics ◽  
The United States ◽  
Off Label Use ◽  
Off Label ◽  
National Trends ◽  
Label Use
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