Study: Rates of Off-Label Prescribing of Antidepressants Increasing
Rates of off-label prescribing of antidepressants are increasing, according to the results of a recent study.
Over the last 20 years, antidepressant use has increased in the United States. It is generally believed that this increase is due to antidepressants being prescribed for off-label indications, such as pain and insomnia, but because treatment indications often remain undocumented, the frequency with which physicians prescribe antidepressants for nondepressive indications is unknown.
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To better understand the increase in off-label prescription of antidepressants, the researchers analyzed the prevalence of treatment indications for antidepressants and assessed trends in antidepressant prescribing for depression.
The researchers examined electronic medical records from the Medical Office of the 21st Century (MOXXI) research platform for adults being prescribed antidepressants in Quebec, Canada, from 2006 through 2015.
Antidepressants, excluding monoamine oxidase inhibitors, were categorized as on-label or off-label based on whether they were approved for the indication by Health Canada or the US Food and Drug Administration by September 2015.
Overall, 101,759 prescriptions were written for antidepressants by 158 physicians for 19,734 patients. Of those, 55% were written for depression, and 45% were written for nondepressive indications, including 19% for anxiety, 10% for insomnia, 6% for pain, and 4% for panic disorders.
Off-label indications included insomnia, pain, migraine, menopausal hot flashes, attention-deficit/hyperactivity disorder, and digestive system disorders.
The authors concluded that the study highlights a need to push for more careful evaluation of the uses of antidepressants,
—Amanda Balbi
Reference:
Wong J, Motulsky A, Eguale T, Buckeridge DL, Abrahamowicz M, Tamblyn R. Treatment indications for antidepressants prescribed in primary care in Quebec, Canada, 2006-2015 [published online May 24, 2016]. JAMA. doi:10.1001/jama.2016.3445.