Antipsychotics Increasingly Prescribed for “Off-Label” Conditions

A growing number of patients are receiving “off-label” prescriptions for a class of drugs called atypical antipsychotics, according to The Washington Post. These drugs are increasingly being prescribed to treat anxiety, attention deficit, sleep problems, behavior problems in toddlers, and other conditions for which they are not approved by the U.S. Food and Drug Administration.

Atypical antipsychotics, such as Seroquel, Zyprexa and Abilify, are approved to treat mental illnesses including schizophrenia and bipolar disorder. Some also have been approved to treat severe depression, the article notes.

A recent study found prescriptions for antipsychotics for non-approved uses doubled between 1995 and 2008—from 4.4 million to 9 million.

“Antipsychotics are overused, overpriced and oversold,” Allen Frances, former Chair of Psychiatry at Duke University School of Medicine, told the newspaper. He said in some cases, off-label use of these medicines may be appropriate for patients who have not responded to other treatments for certain conditions, such as obsessive-compulsive disorder. He added that they are being used “promiscuously, recklessly,” in many cases to control behavior. He points out the drugs have serious side effects, including rapid, major weight gain, diabetes, irreversible facial tics, and breast development in boys. The drugs also increase the risk of death in the elderly.

One factor driving the rise in antipsychotic prescriptions is the growing number of non-psychiatrists prescribing them, says James H. Scully Jr., Medical Director of the American Psychiatric Association. Many of these doctors do not have the experience and expertise to properly diagnose and treat mental illness, he said.

Among children, antipsychotic prescriptions are growing in large part because of the increase in bipolar disorder diagnoses, experts say.