Off-Label Use of Atypical Antipsychotics: An Update
Gaps in Knowledge
The comparative effectiveness review revealed areas where the evidence is inadequate to answer many questions about the benefits and adverse effects of off-label use of atypical antipsychotics. The evidence is insufficient to understand the effects of age (with the exception of adverse effects in patients with dementia), race, ethnicity, and baseline severity of disease on outcomes of treatment for off-label indications. For most drugs and indications, there are too few studies to permit conclusions about dosage and duration of treatment.
There are few head-to-head comparisons of atypical and typical antipsychotics, either within or between classes, for treating off-label indications. Adverse event reporting is not standardized, preventing global analysis and understanding of risks. Evidence about the effects of antipsychotics on endocrine function, metabolic, or blood glucose regulation is limited.
- Maglione M, Ruelaz Maher A, Hu J, et al. Off-Label Use of Atypical Antipsychotics: An Update. Comparative Effectiveness Review No. 43 (Prepared by the Southern California RAND Evidence-based Practice Center under Contract No. HHSA 290-2007-10062-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11(12)-EHC087-EF. Available at www.effectivehealthcare.ahrq.gov/offlabelantipsych.cfm.
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