ArticlePloS one2018
Patterns and predictors of off-label prescription of psychiatric drugs.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Efficacy and safety of non-benzodiazepine and non-Z-drug hypnotic medication for insomnia in older people: a systematic literature review.European journal of clinical pharmacology · 2020Pooled it
- A prospective observational study on the off-label use of medications in the psychiatry outpatient department of a tertiary care hospital.Indian journal of pharmacology · 2026Observational
- Insurance-based Disparities in Pediatric Psychiatric Hospitalizations from 2018 to 2021: Examining Mental Health Outcomes among Medicaid and Commercially Insured Youth.The Psychiatric quarterly · 2026Article
- Review
- Off-label policy through the lens of trazodone usage and spending in the United States.Health affairs scholar · 2025Article
- Real-world pharmacotherapy treatment patterns among patients diagnosed with postpartum depression in the United States.BMC psychiatry · 2025Article
- How pharmacology can aid in the diagnosis of mental disorders.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- There ain't such a thing as a free lunch: Pharmaceutical company payments to Australian psychiatrists.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2023Article
- Off-label use of antidepressants, antipsychotics, and mood-stabilizers in psychiatry.Journal of neural transmission (Vienna, Austria : 1996) · 2022Article
- Article
- The Cannabis Ask: What's a Psychiatrist to Do?Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2022Article
- GABAFrontiers in psychiatry · 2022Review
- Assessment of Knowledge, Attitude, and Practice of Obstetricians and Gynecologists Toward Off-Label Medicine Use in Female Reproductive Health Issues.Frontiers in public health · 2022Article
- Patterns and Predictors of Off-Label Drug Prescribing in Psychiatric Practice: A Qualitative Study.Pharmacy (Basel, Switzerland) · 2021Article
- Stroke Risk Among Non-Elderly Users of Haloperidol or First-Generation Antipsychotics vs Second-Generation Antipsychotics: A Cohort Study from a US Health Insurance Claims Database.Drugs - real world outcomes · 2021Article
- Off-Label Medication: From a Simple Concept to Complex Practical Aspects.International journal of environmental research and public health · 2021Review
- Factors Associated With Off-Label Utilization of Second-Generation Antipsychotics Among Publicly Insured Adults.Psychiatric services (Washington, D.C.) · 2021Article
- Serotonin Syndrome/Serotonin Toxicity.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2020Review
- Takotsubo Cardiomyopathy Due to Combined Use of Phentermine and Lisdexamfetamine.European journal of case reports in internal medicine · 2020Article
- "Madness and Despair are a Force": Global Mental Health, and How People and Cultures Challenge the Hegemony of Western Psychiatry.Culture, medicine and psychiatry · 2019Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
Off-label prescribing of psychiatric drugs is common, despite lacking strong scientific evidence of efficacy and potentially increasing risk for adverse events. The goal of this study was to characterize prevalence of off-label prescriptions of psychiatric drugs and examine patient and clinician predictors of off-label use. This manuscript presents a retrospective, cross-sectional study using data from the 2012 and 2013 National Ambulatory Medical Care Surveys (NAMCS). The study examined all adult outpatient visits to psychiatric practices for chronic care management with a single listed visit diagnosis in which at least one psychiatric drug was prescribed. The main outcome measure was off-label prescribing of at least one psychiatric drug, defined as prescription for a condition for which it has not been approved for use by the FDA. Among our sample representative of 1.85 billion outpatient visits, 18.5 million (1.3%) visits were to psychiatrists for chronic care management in which at least one psychiatric drug was prescribed. Overall, the rate of off-label use was 12.9% (95% CI: 12.2-15.7). The most common off-label uses were for manic-depressive psychosis treated with citalopram and primary insomnia treated with trazodone. Several patient and clinician characteristics were positively associated with off-label prescribing, including seeing a psychiatrist (OR: 1.06, 95% CI, 1.01-1.12; p = 0.03) instead of another type of clinician, the office visit taking place in the Western region of the country (OR: 1.09, 95% CI, 1.01-1.17; p = 0.02), and the patient having 3 or more chronic conditions (OR: 1.12, 95% CI, 1.02-1.14; p = 0.003). In contrast, having Medicare coverage (OR: 0.93, 95% CI, 0.84-0.97; p = 0.04) and receiving payment assistance from a medical charity (OR: 0.91, 95% CI, 0.88-0.96; p = 0.03) instead of private insurance were negatively associated with off-label prescribing. These results suggest that certain classes of psychiatric medications are being commonly prescribed to treat conditions for which they have not been determined by the FDA to be clinically efficacious and/or safe.
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Registered trials
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