ArticleThe Australian and New Zealand journal of psychiatry2024
On- and off-label utilisation of antipsychotics in Australia (2000-2021): Retrospective analysis of two medication datasets.
Article in The Australian and New Zealand journal of psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Cardiometabolic adverse effects of long-term antipsychotic treatment in children and adolescents with non-psychotic disorders: a systematic review of available evidence.European child & adolescent psychiatry · 2025Pooled it
- Quetiapine modestly improves sleep and breathing but impairs next-day performance in people with obstructive sleep apnea and difficulty maintaining sleep: a randomized controlled trial.Annals of the American Thoracic Society · 2026Trial
- Trial
- Cardiovascular risk management in patients using antipsychotics: a qualitative feasibility study.BJGP open · 2026Article
- Antipsychotic treatment patterns and cardiometabolic medicine use: current real-world evidence.Epidemiology and psychiatric sciences · 2026Article
- Antipsychotic off-label use in the 21st century: An enduring public health concern.Dialogues in clinical neuroscience · 2025Review
- Patterns and indications for quetiapine prescribing in Dutch primary care: a retrospective database study.BJGP open · 2025Article
- Real-World Prescribing Patterns of Long-Acting Injectable Antipsychotics in Australian Psychiatric Inpatients: Trends, Clinical Outcomes, and Substance Use Prevalence.Drugs - real world outcomes · 2025Article
- Psychotropic medications versus non-pharmacologic approaches for managing behavioural and psychological symptoms in Australian aged care residents with dementia: general practitioners' and physicians' perspectives.Therapeutic advances in psychopharmacology · 2025Article
- Re-evaluating methodological approaches in assessing psychiatric history and outcomes post-aSAH: A commentary on Paavola et al.Brain & spine · 2025Article
- Acute Quetiapine Intoxication: Relationship Between Ingested Dose, Serum Concentration and Clinical Presentation-Structured Literature Review and Analysis.Journal of xenobiotics · 2024Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine antipsychotic utilisation patterns in Australian adults from 2005 to 2021, with a focus on on-label and off-label prescriptions.
methodsWe examined antipsychotic dispensing trends in adults from 2005 to 2021 using a 10% sample of the Pharmaceutical Benefits Scheme (PBS) dataset, which contains patient-level information on medicines dispensed throughout Australia. The lack of diagnostic information in PBS was substituted by analysing BEACH (Bettering the Evaluation And Care of Health) dataset, a cross-sectional national survey from 2000 to 2016, consisting of data from general practitioner-patient encounters.
resultsThere were 5.6 million dispensings for 164,993 patients in PBS throughout this period; 69% patients had >1 dispensing, with a median of 6 per patient. Calculating the estimated period of exposure gave a total of 693,562 treatment episodes, with a median duration of 80 days. There were steady increases in both the incidence and prevalence of antipsychotic dispensings, mainly due to oral second-generation antipsychotics. The most commonly prescribed antipsychotics were quetiapine, olanzapine and risperidone, with a significant portion of patients receiving low-dose quetiapine without dose titration. Analysis of diagnostic indications from BEACH indicated that 27% of antipsychotic prescriptions were off-label for indications such as depression, dementia, anxiety and insomnia, at much lower prescribed daily dosages.
conclusionThe increasing prescribing and off-label use highlights concerns about chronic adverse effects caused by antipsychotics. The combined analysis of medication dispensings and the diagnostic indications for which they are prescribed is a novel approach and throws a spotlight on the need for additional monitoring of antipsychotics.
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