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Off-label prescribing of antipsychotics: prescribing practices and clinical experiences of Finnish physicians
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Off-label prescribing of antipsychotics: prescribing practices and clinical experiences of Finnish physicians
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Journal Article
Off-label prescribing of antipsychotics: prescribing practices and clinical experiences of Finnish physicians
2022
Overview
IntroductionOff-label use of antipsychotics has increased in many countries. In adult populations antipsychotics off-label prescriptions varied from 40 to 75% of all AP users.ObjectivesTo examine the off-label prescribing practices and experiences of antipsychotic medication in Finland.MethodsAn electronic questionnaire on physicians’ prescription practices of antipsychotics, especially for off-label use, was sent in 2019 for physicians (n=1195) in different health care facilities including primary health care, occupational health care, in- and outpatient mental health services and services for substance abuse. The sample was selected by systematic and convenience sampling covering five university hospital areas in Finland.ResultsIn total, 216 physicians (18% of the target sample) participated in the study, and 94% had prescribed antipsychotics for off-label use. The most common off-label indications were insomnia and anxiety. The most common antipsychotic used was quetiapine. Off-label antipsychotics was not prescribed as a first-choice medication: 99% of the physicians reported that the patients with off-label use have previously had other medications for the corresponding symptoms. In all, 88% of clinicians monitored the patients’ clinical condition, whereas metabolic values were followed more rarely. About 68% of physicians reported more benefit than harm from the antipsychotics off-labeluse.ConclusionsAntipsychotics are often prescribed for off-label use, most commonly for insomnia and anxiety. Most of the physicians see more benefits than harms for the patient in off-label use. There is a need to analyse the long-term benefits and harms of off-label use of antipsychotics and create more detailed treatment algorithms and clinical recommendations for such use.DisclosureNo significant relationships.
Publisher
Cambridge University Press
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