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

• Main Authors: Pirhonen, E. (Eero), Haapea, M. (Marianne), Rautio, N. (Nina), Nordström, T. (Tanja), Turpeinen, M. (Miia), Laatikainen, O. (Outi), Koponen, H. (Hannu), Silvan, J. (Jenni), Miettunen, J. (Jouko), Jääskeläinen, E. (Erika)
• Format: Article in Journal/Newspaper
• Language: English
• Published: John Wiley & Sons 2022
• Subjects: antipsychotic agent; comorbidity; mental disorders; off-label use; socioeconomic status; Northern Finland
• Online Access: http://urn.fi/urn:nbn:fi-fe2023060552557

Abstract 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. Conclusions: 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.