More Than Half of Antipsychotic Prescriptions Aren't for FDA-Approved Disorders

Marcia Purse Health Guide
  • A study at the Penn State College of Medicine says that "reducing the non-FDA-approved use of antipsychotic drugs may be a way to save money while having little effect on patient care." The researchers determined that 57.6% of antipsychotic prescriptions were for illnesses other than schizophrenia and bipolar disorder.

     

    While the study itself may go into greater detail, the article talking about it seems to me to be kind of misleading. Consider the figures:

    • 42.4% - schizophrenia or bipolar
    • 35.0% - other mental disorders
    • 25.4% - minor depression
    • 23.2% - major depression
    • 18.8% - no mental disorder
    • 18.8% - conduct disorder
    • 16.2% - anxiety disorder

    These figures add up to 179.8%, so obviously some patients without bipolar or schizophrenia had more than one disorder. Is it possible that some of the 35% "other mental disorders" include other illnesses where psychosis is present like schizoaffective disorder, schizophreniform disorder, brief reactive psychosis, etc.?

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    The reporting article does mention that the data was gathered before some antipsychotics like Abilify were approved for use in treatment-resistant depression, so that's one way the results are skewed.

     

    Some important points: It's illegal for a drug manufacturer to market a medication for off-label uses. Several pharmaceutical companies have gotten nailed for doing just that. But it's not illegal for a doctor to prescribe a drug - any drug - for off-label use.

     

    Now, I'm not here to say that there aren't too many off-label prescriptions for antipsychotics. Why in the world would somebody prescribe a drug like Zyprexa or Seroquel for someone who doesn't have a mental disorder at all? In addition, Conduct Disorder is a childhood condition. As far as I know, no antipsychotics are FDA-approved to treat Conduct Disorder, and to expose children to the dangers of these drugs needlessly is unconscionable.

     

    Obviously, as the reporting article says, "Further research is needed on the decision-making process of doctors to prescribe off-label." Antipsychotics are expensive and can have severe side effects, from substantial weight gain to diabetes to movement disorders such as tardive dyskinesia.

     

    And I'm proof that this is no joke. While taking psych meds I've gained a lot of weight, my blood pressure and cholesterol went up because of that, I developed diabetes, and I have small, repetitive tongue movements that are a sign of tardive dyskinesia. Most of the excess weight came from Seroquel.

     

    Working with my doctor, I've gotten down to a very small dose of Seroquel, just 50 mg a day. I tried to drop it completely, but it quickly became clear I do need that small dose. I've never had a psychotic episode or even psychotic symptoms, but Seroquel is approved to treat bipolar depression, too, and I've got plenty of that.

     

    The bottom line for me is that based on those figures, especially the 18.8% of people having no mental disorder at all and the 18.8% with Conduct Disorder, money is being wasted and both adults and children are being endangered by off-label prescribing of antipsychotics. Let's hope that further research happens soon, because it's time to stop the practice of giving people drugs they don't need.

Published On: May 26, 2012