Over two thirds of off-label antipsychotic prescriptions in children are for uses where there is only uncertain evidence of efficacy.
The authors used nationally representative data from 4,800 physicians in the IMS Health National Diagnostic and Therapeutic Index from 1995-2008. The number of treatment visits among children that included an antipsychotic prescription increased eight-fold during this period, with two-thirds of off-label use in 2008 supported by little clinical evidence.
From the source:
| Atypical antipsychotic use in youth < 18 years by FDA indication | 1995-1996 | 1997-1998 | 1999-2000 | 2001-2004 | 2003-2004 | 2005-2006 | 2007-2008 |
| Total Prescriptions | 120,000 | 472,000 | 977,000 | 1,774,000 | 3,518,000 | 4,520,000 | 4,216,000 |
| On-label use | 12% | 12% | 21% | 23% | 24% | 26% | 24% |
| Off-label use, moderate to good evidence exists | 33% | 27% | 24% | 18% | 12% | 8% | 9% |
| Off-label use, uncertain evidence | 55% | 61% | 55% | 58% | 64% | 66% | 67% |
Values and column percents exclude the approximate 1%-2% of subjects whose age were not specified;
Source: IMS National Disease and Therapeutic Index™, 1995-2008 and DrugDex™
Tags:
Antipsychotic medication, Off-label use of medication, Children’s mental health
Citation:
Alexander GC, Gallagher SA, Mascola A, Moloney RM, Stafford RS. Increasing off-label use of antipsychotic medications in theUnited States, 1995-2008. Pharmacoepidemiol Drug Saf. 2011; 20(2):177-184.
