ArticleCNS drugs2012
Off-label use of atypical antipsychotics: cause for concern?
Article in CNS drugs, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 64 citations in OpenAlex.
- Trends in antipsychotic and lithium use in Scandinavian countries from 2010 to 2023: a cross-country drug utilization study.BMC psychiatry · 2026Article
- Patterns and appropriateness of antipsychotic prescribing in community-dwelling older adults: a retrospective study.Frontiers in pharmacology · 2026Article
- Antipsychotic off-label use in the 21st century: An enduring public health concern.Dialogues in clinical neuroscience · 2025Review
- Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit.BJPsych open · 2024Article
- Consumption of psychotropic drugs in Croatia before and during the COVID-19 pandemic: a 10-year longitudinal study (2012-2021).Social psychiatry and psychiatric epidemiology · 2024Article
- On- and off-label utilisation of antipsychotics in Australia (2000-2021): Retrospective analysis of two medication datasets.The Australian and New Zealand journal of psychiatry · 2024Article
- Patterns of suboptimal antipsychotic use and misuse in Australia: What can routinely collected data tell us?British journal of clinical pharmacology · 2023Article
- Off-label use of antidepressants, antipsychotics, and mood-stabilizers in psychiatry.Journal of neural transmission (Vienna, Austria : 1996) · 2022Article
- Review of antipsychotic prescribing at HMP/YOI Low Newton.BJPsych bulletin · 2022Review
- Pregnancy-related claustrophobia.BMJ case reports · 2022Article
- Prevalence of Central Nervous System-Active Polypharmacy Among Older Adults With Dementia in the US.JAMA · 2021Article
- Repurposing existing drugs for new uses: a cohort study of the frequency of FDA-granted new indication exclusivities since 1997.Journal of pharmaceutical policy and practice · 2021Article
- Prescription Pattern and Off-Label Use of Antipsychotics in a Middle Eastern Population.Frontiers in pharmacology · 2021Article
- Off-label use of quetiapine in nursing homes: Does medical specialty of prescribing physicians play a role?British journal of clinical pharmacology · 2020Article
- Trends in utilization and dosing of antipsychotic drugs in Scandinavia: Comparison of 2006 and 2016.British journal of clinical pharmacology · 2019Article
- Rates of new antipsychotic prescriptions and continuation at discharge from a medical unit in a community teaching hospital serving rural counties.The mental health clinician · 2019Article
- Cannabis regulatory science: risk-benefit considerations for mental disorders.International review of psychiatry (Abingdon, England) · 2018Review
- The lesser of two evils: a qualitative study of quetiapine prescribing by family physicians.CMAJ open · 2018Article
- Off-label prescription of psychiatric drugs by non-psychiatrist physicians in three general hospitals in Germany.Annals of general psychiatry · 2018Article
- Psychotropic polypharmacy in Australia, 2006 to 2015: a descriptive cohort study.British journal of clinical pharmacology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Licensed indications for medicines were designed to regulate the claims that can be made about a medicine by a pharmaceutical company. Off-label prescribing (i.e. prescribing a drug for an indication outside of that for which it is licensed) is legal and an integral part of medical practice. In psychiatry, off-label prescribing is common and gives clinicians scope to treat patients who are refractory to standard therapy or where there is no licensed medication for an indication. However, efficacy or safety of such off-label use may not be established. There is a growing list of licensed indications for atypical antipsychotics (AAP) beyond schizophrenia and bipolar affective disorder, and also more evidence for other indications where pharmaceutical companies have not obtained a license. Pharmaceutical companies have promoted AAPs for off-label indications to increase sales and consequently have been fined by the US FDA for this. Since the 1990s, AAP use has expanded considerably, for example, the off-label use of quetiapine alone accounted for an estimated 17% of the AAP spend in New Zealand in 2010. There are a number of potential problems with the expanded use of AAPs outside of schizophrenia and related psychoses. A larger population will be exposed to their adverse effects, which include weight gain, type 2 diabetes mellitus, sudden cardiac death and increased mortality rates in the elderly with dementia. There are also concerns with the abuse of these agents, in particular quetiapine. Given that an increasing percentage of the population is being treated with these agents, off-label prescribing of AAPs is a cause for concern; they have a propensity to cause significant side effects and their efficacy and long-term safety for most off-label indications remains largely unknown, and therefore the risks and benefits of their use should be carefully weighed up prior to prescribing these agents off-label.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.