Characteristics and predictors of off-label use of antipsychotics in general population sample

• Published in: Acta Psychiatrica Scandinavica
• Main Authors: Pirhonen, Eero, Haapea, Marianne, Rautio, Nina, Nordstrom, Tanja, Turpeinen, Miia, Laatikainen, Outi, Koponen, Hannu, Silvan, Jenni, Miettunen, Jouko, Jääskeläinen, Erika
• Other Authors: HUS Psychiatry, Department of Psychiatry, Clinicum, University of Helsinki
• Format: Article in Journal/Newspaper
• Language: English
• Published: Hindawi 2022
• Subjects: antipsychotic agent; comorbidity; mental disorders; off-label use; socioeconomic status; PRIMARY INSOMNIA; QUETIAPINE; TRENDS; DRUG; 3124 Neurology and psychiatry; Northern Finland
• Online Access: http://hdl.handle.net/10138/347373

Objective Increasing number of people have been prescribed antipsychotics (APs) off-label in recent decades. This study aimed to identify the characteristics and predictors of receiving prescription of antipsychotics off-label. Methods The study sample was part of the Northern Finland Birth Cohort 1966 (n = 7071). Data included questionnaires and national register data. Information on prescribed medications was extracted from the national register. The sample was divided into three groups: Persons who had been prescribed APs off-label (n = 137), individuals with non-psychotic mental disorders without APs off label (n = 1478) and individuals who had been diagnosed with psychosis or bipolar disorder and who had been prescribed APs (n = 151). We compared sociodemographic, lifestyle and clinical characteristics between the off-label and the comparison groups using logistic regression. Results The most common diagnoses in the off-label group were depression (n = 96, 70.1%) and anxiety (n = 55, 40.1%). Compared with individuals with non-psychotic mental disorders who were not prescribed APs off-label, individuals with prescribed off-label APs had a lower level of education, lower socioeconomic status, were less often married, had a higher level of somatic and psychiatric morbidity, were more often smokers and more often had a substance abuse disorder and heavy alcohol consumption. When comparing the off-label group to individuals with psychosis or bipolar disorder who used APs, there were less differences, though individuals with psychosis or bipolar disorder had more markers of morbidity and a lower level of education. Conclusion Individuals who had been prescribed APs off label had a higher level of mental and somatic morbidity and poorer socioeconomic status than individuals with non-psychotic mental disorders who did not use APs. Peer reviewed