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Innappropriate drug prescriptions wasting millions, raising health risks
Date:3/4/2009

the researchers found that the vast majority of the people receiving one of these drugs did not have schizophrenia or bipolar disorder, the underlying mental health conditions for which the drugs had been approved.

Most people who received these "atypical antipsychotic" drugs, which are very powerful and have potentially severe side effects, had less serious mental health concerns such as depression, anxiety, post-traumatic stress disorder or no psychiatric disorder other than insomnia.

The newer antipsychotic drugs can cause side effects such as neuromuscular rigidity, increased risk of stroke, heart arrhythmias, moderate-to-severe weight gain, and worsening glucose control that leads to increased risk of diabetes. The drugs may be necessary for patients with major mental health problems such as schizophrenia, Hartung said, but have not been demonstrated to be effective for most of their off-label uses, such as depression or agitation in persons suffering from dementia.

The prescriptions, he said, were also often given at lower doses and for shorter time periods than anything that has been shown to be therapeutic.

And the concerns involve many types of practitioners, the study found the medications were prescribed by primary care physicians and nurse practitioners and, to a lesser extent, psychiatrists and psychiatric nurse practitioners.

"Some drug companies have been accused of encouraging and expanding the off-label use of drugs, and that may be where part of this misinformation is coming from," Hartung said. "That is an illegal practice, and some companies have been successfully sued on that basis. Regardless of what's causing this, it's a serious concern, both for ensuring resources are used judiciously and protecting health care quality."

These issues should be more carefully explored, the researchers said in their study. They are particularly relevant to Medicaid programs, in which use of antipsychot
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Contact: Daniel Hartung
hartungd@ohsu.edu
503-494-4720
Oregon State University
Source:Eurekalert

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