Off-label use of antipsychotic medications in Medicaid.

摘要: OBJECTIVES To determine how often antipsychotics are prescribed off-label to adults without schizophrenia or bipolar disorder who enrolled in Medicaid, which pays for more than 70% of antipsychotic prescriptions the United States. STUDY DESIGN Retrospective analysis 2003 administrative data from 42 state Medicaid programs. METHODS Continuously patients with at least 1 prescription an medication were identified. For these patients, inpatient and outpatient records checked any diagnosis disorder; those such diagnoses considered have received medications off-label. Offlabel use was compared across sociodemographic groups (age, race/ethnicity, sex). Multivariate logistic regression models identified characteristics associated use. RESULTS Of 372,038 individuals given medication, 214,113 (57.6%) agents disorders. Off-label among receiving prevalent under age 21 years (75.9%) 65 older (64.8%) it aged 64 (49.0%). Rates relatively high Hispanics (65.7%) low African Americans (52.3%) whites (58.2%). most common risperidone clozapine. CONCLUSIONS is common, particularly elderly children/adolescents. Given that drugs expensive, potentially severe side effects, limited evidence supporting their effectiveness off-label, they should perhaps be used greater caution.