Off-label prescribing by psychiatrists
2006
AIMS AND METHOD To report on the use of atypical antipsychotics in one health district by
examining secondary care prescribing patterns for these medicines in North
Staffordshire between 1994 and 2001. With one exception, these drugs were
licensed solely for use in schizophrenia during the study period. RESULTS A total of 502 patients were initiated on atypical antipsychotics in the
study period. Of these, 297 (59.2%) had a diagnosis of schizophrenia (ICD-10
codes F20-29). Off-label prescribing was common, but psychiatrists were least
likely to prescribe clozapine off-label (2.2%). Affective (18.4%) and organic
disorders (12.4%) were the main disorders treated off-label. Olanzapine had
the highest off-label use (44.5%). CLINICAL IMPLICATIONS The high off-label use of atypical antipsychotics has clinical and economic
implications. Although off-label prescribing may be in the patient’s
best interests, they should be informed and give their consent. Commissioning
bodies, such as primary care organisations, are basing their budgets on
guidance from the National Institute for Clinical Excellence, which can have
implications for funding this off-label use.
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