Abstract
Introduction: New antipsychotics continuously arrive on the market, which thereby influences the approved and off-label prescribing (OLP) schemes. We aimed to identify the recent trends in the OLP of antipsychotics. We conducted a literature review based on three different populations: adult, pediatric, and elderly patients. Methods: A literature search was performed in the PubMed and ScienceDirect databases using the following keyword algorithm: “offlabel” AND (“antipsychotic*” OR “neuroleptic*”). The period investigated ranged from January 2000 to January 2015. Only Englishwritten pharmacoepidemiological studies were included.
Results: Seventy-seven relevant results were identified. Among adults, OLP consisted of 40 to 75% of all antipsychotic prescriptions. The main indications were mood disorders, anxiety disorders, insomnia and agitation. Quetiapine was the most frequently prescribed offlabel antipsychotic, especially for anxiety and insomnia. Among children, OLP was estimated between 36 and 93.2% of all antipsychotic prescriptions. Risperidone and aripiprazole were primarily used and were most often prescribed for attention deficit hyperactivity disorder, anxiety, or mood disorders. Among elderly individuals, OLP consisted of 22 to 86% of all antipsychotic prescriptions. Antipsychotic OLP was particularly frequent for agitation; however, a recent decrease in this OLP was identified.
Discussion: Antipsychotics have largely been prescribed off-label in recent years. The types of antipsychotic OLP practices differ according to the age category of patients. OLP is often used in cases of therapeutic dead-ends or for specific disorders with few or no currently approved medications. However, other OLP practices only reflect temporary prescription trends for mild symptoms, which may induce safety concerns.
Keywords: Adults, antipsychotics, children, elderly, off-label, pharmacoepidemiology, safety.
Current Pharmaceutical Design
Title:Off-Label Prescribing of Antipsychotics in Adults, Children and Elderly Individuals: A Systematic Review of Recent Prescription Trends
Volume: 21 Issue: 23
Author(s): Louise Carton, Olivier Cottencin, Maryse Lapeyre-Mestre, Pierre A. Geoffroy, Jonathan Favre, Nicolas Simon, Regis Bordet and Benjamin Rolland
Affiliation:
Keywords: Adults, antipsychotics, children, elderly, off-label, pharmacoepidemiology, safety.
Abstract: Introduction: New antipsychotics continuously arrive on the market, which thereby influences the approved and off-label prescribing (OLP) schemes. We aimed to identify the recent trends in the OLP of antipsychotics. We conducted a literature review based on three different populations: adult, pediatric, and elderly patients. Methods: A literature search was performed in the PubMed and ScienceDirect databases using the following keyword algorithm: “offlabel” AND (“antipsychotic*” OR “neuroleptic*”). The period investigated ranged from January 2000 to January 2015. Only Englishwritten pharmacoepidemiological studies were included.
Results: Seventy-seven relevant results were identified. Among adults, OLP consisted of 40 to 75% of all antipsychotic prescriptions. The main indications were mood disorders, anxiety disorders, insomnia and agitation. Quetiapine was the most frequently prescribed offlabel antipsychotic, especially for anxiety and insomnia. Among children, OLP was estimated between 36 and 93.2% of all antipsychotic prescriptions. Risperidone and aripiprazole were primarily used and were most often prescribed for attention deficit hyperactivity disorder, anxiety, or mood disorders. Among elderly individuals, OLP consisted of 22 to 86% of all antipsychotic prescriptions. Antipsychotic OLP was particularly frequent for agitation; however, a recent decrease in this OLP was identified.
Discussion: Antipsychotics have largely been prescribed off-label in recent years. The types of antipsychotic OLP practices differ according to the age category of patients. OLP is often used in cases of therapeutic dead-ends or for specific disorders with few or no currently approved medications. However, other OLP practices only reflect temporary prescription trends for mild symptoms, which may induce safety concerns.
Export Options
About this article
Cite this article as:
Carton Louise, Cottencin Olivier, Lapeyre-Mestre Maryse, Geoffroy A. Pierre, Favre Jonathan, Simon Nicolas, Bordet Regis and Rolland Benjamin, Off-Label Prescribing of Antipsychotics in Adults, Children and Elderly Individuals: A Systematic Review of Recent Prescription Trends, Current Pharmaceutical Design 2015; 21 (23) . https://dx.doi.org/10.2174/1381612821666150619092903
DOI https://dx.doi.org/10.2174/1381612821666150619092903 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Lysosomal Modulatory Drugs for a Broad Strategy Against Protein Accumulation Disorders
Current Alzheimer Research Protective Effects of Polydatin Against Dementia-Related Disorders
Current Neuropharmacology The Delivery of Personalised, Precision Medicines <i>via</i> Synthetic Proteins
Drug Delivery Letters Overview of Pediatric Epilepsy
Current Pediatric Reviews The Molecular Genetics of Migraine: Toward the Identification of Responsible Genes
Current Genomics The Association and Influencing Factors between Antipsychotics Exposure and the Risk of VTE and PE: A Systematic Review and Meta-analysis
Current Drug Targets Neurophysiology of Sleep and Wakefulness: Basic Science and Clinical Implications
Current Neuropharmacology Nuances in Alzheimer’s Genetic Risk Reveal Differential Predictions of Non-demented Memory Aging Trajectories: Selective Patterns by APOE Genotype and Sex
Current Alzheimer Research Posterior Reversible Encephalopathy Syndrome in Leukemic Children: A Sensitive Issue
Current Drug Safety Tetracyclic Triterpenoids in Herbal Medicines and their Activities in Diabetes and its Complications
Current Topics in Medicinal Chemistry Alzheimer Biomarkers and Clinical Alzheimer Disease were Not Associated with Increased Cerebrovascular Disease in a Memory Clinic Population
Current Alzheimer Research Conference Report: (13th International Congress on Amino Acids, Peptides and Proteins (ICAPP); Neurobiology Symposium, October 5-7, 2013; Galveston TX, USA.)
CNS & Neurological Disorders - Drug Targets Obstructive Sleep Apnea and Stroke
Current Respiratory Medicine Reviews Mitochondrial Biology and Neurological Diseases
Current Neuropharmacology In vitro Antioxidant and Acetylcholinesterase Inhibitory Activities of Fractions from Centella asiatica (Linn.) Extract
Current Bioactive Compounds Age-Related Mitochondrial Alterations without Neuronal Loss in the Hippocampus of a Transgenic Model of Alzheimer's Disease
Current Alzheimer Research Resveratrol Protects β Amyloid-Induced Oxidative Damage and Memory Associated Proteins in H19-7 Hippocampal Neuronal Cells
Current Alzheimer Research Flavonoids in Human Health: From Structure to Biological Activity
Current Nutrition & Food Science Semantic Intrusions and Failure to Recover From Semantic Interference in Mild Cognitive Impairment: Relationship to Amyloid and Cortical Thickness
Current Alzheimer Research Coumarin Compounds in Medicinal Chemistry: Some Important Examples from the Last Years
Current Topics in Medicinal Chemistry