TUESDAY, Sept. 27 (HealthDay News) -- Even though off-label use
of atypical antipsychotic drugs is common, a new review finds that
such use is only effective in a few conditions and can be harmful
Also known as "second-generation" antipsychotics, these drugs
are approved in the United States for treatment of schizophrenia,
bipolar disorder and depression. But off-label use -- or use not
approved by the U.S. Food and Drug Administration -- of these drugs
to treat a number of other conditions is growing.
Researchers analyzed findings from 393 clinical studies to gauge
effectiveness and uncover harmful side effects when Risperdal,
Zyprexa, Seroquel, Abilify, Geodon, Saphris, Fanapt and Invega were
used outside of FDA-approved indications.
Off-label use included treatment for behavioral symptoms in
dementia, anxiety, depression, obsessive-compulsive disorder,
eating disorders, post-traumatic stress disorder, insomnia,
personality disorders and substance abuse.
The investigators found that Abilify (aripiprazole), Zyprexa
(olanzapine) and Risperdal (risperidone) were associated with small
but statistically significant benefits for elderly people with
dementia symptoms, such as aggression, psychosis and mood
Seroquel (quetiapine) was 26 percent more effective than placebo
in people with generalized anxiety disorder, and Risperdal was four
times more effective than placebo in people with
There was no evidence that atypical antipsychotics benefited
people with substance abuse or eating disorders, according to Dr.
Alicia Ruelaz Maher, of RAND Health in Santa Monica, Calif., and
The researchers also found that certain atypical antipsychotics
increased the risk of death, stroke, movement disorders and urinary
tract symptoms in elderly patients. In younger patients, some of
the drugs caused problems such as weight gain, fatigue, sedation,
and akathisia, also known as restless leg syndrome.
The study is published in the Sept. 28 issue of the
Journal of the American Medical Association.
"The benefits and harms vary among atypical antipsychotic medications for off-label use," the researchers concluded in a journal news release. "This evidence should prove useful for clinicians considering off-label prescribing of atypical antipsychotic medications, and should contribute to optimal treatment decision making for individual patients with specific clinical symptoms and unique risk profiles."
The U.S. National Institute of Mental Health has more about
mental health medications.