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A recent study showed that about half of antidepressants prescribed by Quebec primary care clinicians were for off-label, nondepression indications, such as anxiety, pain, and insomnia (NEJM JW Gen Med Jul 1 2016 and JAMA 2016; 315:2230). Now, the same researchers analyzed this data set again to investigate the frequency of, and scientific evidence supporting, off-label antidepressant prescriptions.
Their findings were as follows:
Of 107,000 antidepressant prescriptions, written for 21,000 adults, 29% were for off-label indications.
By class, tricyclic antidepressants (TCAs) showed the highest prevalence of off-label prescribing (81% of all TCA prescriptions) followed by “other” antidepressants (trazodone, bupropion, and mirtazapine; 42%), and…