1. Off-Label Prescribing of Antipsychotics in Adults, Children and Elderly Individuals: A Systematic Review of Recent Prescription Trends
- Author
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Pierre-Alexis Geoffroy, Louise Carton, Nicolas Simon, Benjamin Rolland, Olivier Cottencin, Jonathan Favre, Régis Bordet, Maryse Lapeyre-Mestre, Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 (GRITA), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille
- Subjects
Mesh:Off-Label Use ,pharmacoepidemiology ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Inappropriate Prescribing ,Mesh:Adult ,off-label ,[SCCO]Cognitive science ,Mesh:Adolescent ,0302 clinical medicine ,Risk Factors ,Mesh:Risk Factors ,Mesh:Antipsychotic Agents/therapeutic use ,Drug Discovery ,Practice Patterns, Physicians' ,Child ,Mesh:Aged ,Mesh:Practice Patterns ,Mesh:Treatment Outcome ,Mesh:Mental Disorders/psychology ,Mental Disorders ,Age Factors ,Middle Aged ,Mesh:Inappropriate Prescribing/trends ,3. Good health ,Treatment Outcome ,Mesh:Age Factors ,Anxiety ,Aripiprazole ,Patient Safety ,medicine.symptom ,Mesh:Mental Disorders/drug therapy ,Mesh:Antipsychotic Agents/adverse effects ,Mesh:Patient Safety ,Antipsychotic Agents ,Mesh:Risk Assessment ,medicine.drug ,Adult ,safety ,medicine.medical_specialty ,Adolescent ,Mesh:Child ,Mesh:Young Adult ,Drug Prescriptions ,Risk Assessment ,elderly ,Young Adult ,03 medical and health sciences ,children ,stomatognathic system ,Mesh:Middle Aged ,medicine ,Humans ,Adults ,Attention deficit hyperactivity disorder ,Medical prescription ,Antipsychotic ,Psychiatry ,Aged ,Pharmacology ,Risperidone ,business.industry ,Off-Label Use ,Mesh:Drug Prescriptions ,medicine.disease ,030227 psychiatry ,antipsychotics ,Mesh:Humans ,stomatognathic diseases ,Mood disorders ,Mesh:Physicians''/trends ,Quetiapine ,business ,Mesh:Mental Disorders/diagnosis ,030217 neurology & neurosurgery - Abstract
International audience; BACKGROUND: 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.CONCLUSIONS: 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.
- Published
- 2015