Off-label prescribing of antipsychotics: prescribing practices and clinical experiences of Finnish physicians. (1st June 2022)

• Record Type: Journal Article
• Authors: Rautio, N.; Ylitolonen, L.; Haapea, M.; Huovinen, H.; Alakokkare, A.-E.; Niemelä, S.; Miettunen, J.; Penttilä, M.; Koponen, H.; Seppälä, J.; Isohanni, M.; Jääskeläinen, E.
• Is Part Of: European psychiatry. Volume 65:Supplement 1(2022)
• Page Start: S344
• Page End: S345
• Publication Date: 2022-06-01
• Subjects: Antipsychotics -- Off-label -- physicians -- Questionnaire; Psychiatry -- Periodicals; Mental illness -- Periodicals; Electronic journals; 616.89
• DOI: 10.1192/j.eurpsy.2022.876
• Languages: English
• ISSNs: 0924-9338

Abstract

Abstract : Introduction: Off-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. Objectives: To examine the off-label prescribing practices and experiences of antipsychotic medication in Finland. Methods: An 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. Results: In 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-label use. Conclusions: Antipsychotics 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. Disclosure: No significant relationships.