There is little evidence to support the use of atypical antipsychotic drugs for some treatments other than their officially approved purposes, even though many clinicians continue to commonly prescribe these drugs for so-called "off label" uses, according to a new report from the U.S. Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ). An article based on information in the report will be published in the September 28 issue of the Journal of the American Medical Association.
The report finds that atypical antipsychotic medications—approved by the U.S. Food and Drug Administration (FDA) for treatment of schizophrenia, bipolar disorder and, in some cases, depression—are commonly prescribed to treat other behavioral conditions.
The report, which is an update of a 2007 report, found some evidence to support the off-label use of atypical antipsychotic medications. Evidence was strongest, for example, for the off-label use of risperidone, olanzapine and aripiprazole to treat symptoms of dementia; quetiapine to treat generalized anxiety disorder; and risperidone to treat obsessive-compulsive disorder.
However, evidence was lacking to justify the use of these and other atypical antipsychotic drugs to treat substance abuse problems, eating disorders or insomnia, the report noted. Atypical antipsychotic medications have been linked to some harms, including a small increased risk of death in elderly patients with dementia, according to the report.
The report, a comparative effectiveness review prepared for AHRQ's Effective Health Care Program by the Southern California Evidence-based Practice Center, based at the RAND Corporation, is available at http://www.effectivehealthcare.ahrq.gov.