Off-Label Use of Atypical Antipsychotics: The Good, the Bad, and the Costly

Studies in 2011 show highly variable benefits, high rates of adverse effects, and some ineffective applications for these typically expensive medications.

Antipsychotics now form the fifth most expensive medication class in the U.S. In 2010, spending was $16.1 billion (aripiprazole, $4.6; quetiapine, $4.4; olanzapine, $3.0 billion [IMS Institute for Healthcare Informatics. The Use of Medicines in the United States: Review of 2010. 2011. Parsippany, NJ]). Meanwhile, prescription of antipsychotics for off-label indications has seen explosive growth. Using industry data, researchers estimated that such prescribing in 2008 occurred in 9 million treatment visits, at an estimated cost of $6 billion, and that 54% of all visits with atypical antipsychotics (AAs) involved off-label uses (Pharmacoepidemiol Drug Saf 20:177).

Anxiety disorder is one area showing growth in off-label applications. Examining…

Author

Joel Yager, MD

Disclosures

Editorial BoardsInternational Journal of Eating Disorders; UpToDate; FOCUS: The Journal of Lifelong Learning in Psychiatry; American Journal of Psychotherapy

Joel Yager, MD

Disclosures

Editorial BoardsInternational Journal of Eating Disorders; UpToDate; FOCUS: The Journal of Lifelong Learning in Psychiatry; American Journal of Psychotherapy