Healthy Skepticism Library item: 11378
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: Journal Article
Chen H, Reeves JH, Fincham JE, Kennedy WK, Dorfman JH, Martin BC.
Off-label use of antidepressant, anticonvulsant, and antipsychotic medications among Georgia medicaid enrollees in 2001.
J Clin Psychiatry 2006 Jun; 67:(6):972-82
http://article.psychiatrist.com/loginInter.asp?ID=10002583
Abstract:
OBJECTIVES: To determine the prevalence of and factors associated with the off-label use of antidepressant, anticonvulsant, and antipsychotic medications.
METHOD: A retrospective analysis of Georgia Medicaid recipients was conducted. Recipients prescribed antidepressant, anticonvulsant, or antipsychotic medications were identified. Logistic regression analysis was used to identify factors associated with off-label use.
RESULTS: A total of 46,976 (75.42%) antidepressant recipients, 38,497 (80.12%) anticonvulsant recipients, and 21,252 (63.62%) antipsychotic recipients received at least 1 of these medications off-label in 2001. The likelihood of receiving off-label medications increased remarkably with advancing age (>or= 65 vs. < 65 years: antidepressant: OR = 5.15, 95% CI = 4.76 to 5.56; anticonvulsant: OR = 4.54, 95% CI = 4.16 to 4.96; antipsychotic: OR = 5.21, 95% CI = 4.82 to 5.63). Although receiving new anticonvulsants launched after 1993 was the strongest predictor (OR = 7.63, 95% CI = 7.07 to 8.23) of receiving off-label anticonvulsant medications, exposure to newer antidepressants and antipsychotics did not confer a higher chance of receiving off-label medications (selective serotonin reuptake inhibitors vs. tricyclic antidepressants: OR = 0.43, 95% CI = 0.40 to 0.45; atypical vs. conventional antipsychotics: OR = 0.76, 95% CI = 0.72 to 0.80).
CONCLUSIONS: The off-label use of antidepressant, anticonvulsant, and antipsychotic medications is highly prevalent. Further research to study the effects of off-label use among this high risk subpopulation may be an important step toward defining the scope of and potential for such use.
Keywords:
MeSH Terms:
Adolescent
Adult
Aged
Anticonvulsants/therapeutic use*
Antidepressive Agents/therapeutic use*
Antipsychotic Agents/therapeutic use*
Drug Labeling
Female
Georgia
Humans
Male
Medicaid/statistics & numerical data*
Middle Aged
Retrospective Studies
Substances:
Anticonvulsants
Antidepressive Agents
Antipsychotic Agents
