ArticleBMC psychiatry2021
Off-label use of antipsychotic medications in psychiatric inpatients in China: a national real-world survey.
Article in BMC psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Tardive dyskinesia in Asia- current clinical practice and the role of neurologists in the care pathway.Frontiers in neurology · 2024Pooled it
- Trends in use of antipsychotics in Germany 2014-2024: a nationwide population-based study.BMC psychiatry · 2026Article
- Efficacy of short-term, low-dose oral olanzapine at reducing perioperative anxiety, pain, and enhancing recovery in patients undergoing primary total joint arthroplasty.International journal of surgery (London, England) · 2026Article
- Antipsychotic off-label use in the 21st century: An enduring public health concern.Dialogues in clinical neuroscience · 2025Review
- Off-label drug use in children and adolescents treated with antidepressants and antipsychotics: results from a prospective multicenter trial.Child and adolescent psychiatry and mental health · 2025Article
- Study on disproportionality in the detection of potential signals between quetiapine and diabetic ketoacidosis.European journal of clinical pharmacology · 2025Article
- Clinical practice guidelines for the treatment of tardive dyskinesia in Europe: A descriptive review.European psychiatry : the journal of the Association of European Psychiatrists · 2025Review
- Neurological Perspectives Should Be Integrated Into the Management of Tardive Dyskinesia-Expert Opinions and Proposed Educational Initiatives in Asia.Journal of movement disorders · 2024Article
- Outpatient Antipsychotic Use and Severe COVID-19: Avoiding the Impact of Age in a Real-World Data Study.The international journal of neuropsychopharmacology · 2024Article
- Exploratory focused pharmacogenetic testing reveals novel markers associated with risperidone pharmacokinetics in Saudi children with autism.Frontiers in pharmacology · 2024Article
- Excessive Daytime Sleepiness and Insomnia Symptoms in Adolescents With Major Depressive Disorder: Prevalence, Clinical Correlates, and the Relationship With Psychiatric Medications Use.Psychiatry investigation · 2023Article
- Functional Neurologic Disorders, disorders to be managed by neurologists, or are neurologists wandering in a dangerous field with inadequate resources?Frontiers in psychiatry · 2023Review
- Patterns and Predictors of Off-Label Drug Prescribing in Psychiatric Practice: A Qualitative Study.Pharmacy (Basel, Switzerland) · 2021Article
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12 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe off-label use of antipsychotic medications is common in many countries, and the extent of such use in psychiatric inpatients in China has not been sufficiently studied. The purpose of this study was to survey the incidence and examine the correlates of off-label antipsychotic use in a large, nationally-representative sample in China.
methodsThis study included discharged psychiatric patients between March 19 and 31, 2019 from 41 tertiary psychiatric hospitals across 29 provinces in China. Their socio-demographic and clinical data were collected and analyzed.
resultsAfter excluding patients with schizophrenia spectrum disorder or bipolar disorder, 981 patients were included in the analysis. Overall, antipsychotics were prescribed to 63.2% (95%CI 60.2-66.2%) of the sample. Antipsychotics were used in a wide spectrum of psychiatric disorders, with the rate being the highest among patients with dissociative (conversion) disorders (89.9, 95%CI 83.0-94.8%), organic mental disorders (81.7, 95%CI 73.1-88.7%), dementia (79.0,95%CI 67.8-87.9%), obsessive-compulsive disorder (77.8, 95%CI 55.7-92.5%), mental disorders due to psychoactive substances (75.3,95%CI 64.7-84.2%), behavioural and emotional disorders with onset usually occurring in childhood and adolescence (71.4, 95%CI 45.5-90.1%), somatoform disorders (63.2, 95%CI 40.8%-82..2%), major depression disorder (53.7,95%CI 48.8-58.6%), anxiety disorder (38.8,95%CI 30.5-47.7%), and insomnia (25.0, 95%CI 8.5-28.9%). The top three most commonly used antipsychotics were olanzapine (29.1%), quetiapine (20.3%) and risperidone (6.8%), and their corresponding average doses were 9.04 ± 5.80 mg/day, 185.13 ± 174.72 mg/day, and 2.98 ± 1.71 mg/day, respectively. A binary logistic regression showed that younger age, having the Employee Health Insurance or Residents Health Insurance, having psychotic symptoms and requiring restraint during hospitalization were significantly associated with off-label use of antipsychotics.
conclusionOff-label use of antipsychotics is very common in psychiatric inpatients in China, mainly with moderate-dose use of single agents. However, the efficacy and safety of this practice is uncertain for many diagnoses and for the elderly. Clinicians should be cautious about this practice while waiting for more research data.
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