Navigation Links
No Evidence to Support Many Off-label Uses of Atypical Antipsychotics

Some newer antipsychotic medications approved to treat schizophrenia and bipolar disorder are being prescribed to millions of Americans for depression, dementia, and other psychiatric disorders// without strong evidence that such off-label uses are effective, according to a new analysis by HHS’ Agency for Healthcare Research and Quality

The federally funded comparative effectiveness review of these drugs – called atypical antipsychotics – identified the medications’ potential for serious side effects while pointing to an “urgent need” for more research into new treatments for the growing population of dementia patients who display severe agitation.

“This report emphasizes the importance of understanding the risks and benefits of different medicines,” said AHRQ Director Carolyn M. Clancy, M.D. “Caution is necessary in the off-label use of atypical antipsychotics, especially when used in the elderly and when the evidence for effectiveness is not good.”

Atypical antipsychotics are second-generation medicines designed to cause fewer neurological complications than conventional antipsychotics. They include aripiprazole (sold as Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon). Each is approved by the Food and Drug Administration to treat schizophrenia and bipolar disorder, and risperidone is also approved to treat irritability in children ages 5 to 16 who have autism.

Some studies suggest that atypical antipsychotics may help patients with mental health conditions for which there are no FDA-approved alternatives. Risperidone and quetiapine, for example, help certain patients with obsessive-compulsive disorder when used in conjunction with antidepressants. Risperidone and olanzapine improve sleep problems, depression, and other symptoms in men with combat-related post-traumatic stress disorder when used to augment therapy with antidepressants or other psychotropic medic ations.

Overall, however, researchers found that much of the scientific evidence for off-label use of antipsychotics was of insufficient quality because studies were too small or lacked scientific rigor.

Review authors evaluating the potential benefits and risks of the medications also found strong evidence that atypical antipsychotics can increase chances of adverse events. Some of the drugs increase risks of stroke, tremors, significant weight gain, sedation, and gastrointestinal problems.

The new review was produced by AHRQ’s Effective Health Care program. It was authored by AHRQ’s Southern California/RAND Evidence-based Practice Center. The center examined 84 published studies on atypical antipsychotics and summarized evidence about several conditions:

Dementia: One analysis showed a small benefit for risperidone and aripiprazole in the treatment of agitation and psychosis. Another suggested olanzapine may help treat psychosis. But a large clinical trial that explored whether risperidone, olanzapine, and quetiapine controlled behavioral disturbances in Alzheimer's patients concluded that the risks of adverse events offset the potential benefits. Overall, analyses identified potential harms as a small increase in the risk of death and increased chances of stroke, neurological problems (such as tremors or muscle contractions), and weight gain.

Depression: For patients who don’t benefit from selective serotonin reuptake inhibitors (SSRIs), the supplemental use of atypical antipsychotics was not helpful, according to research. No studies showed the drugs provided a clear benefit for patients with major depressive disorder with psychotic features. Evidence is conflicting for bipolar depression.

Obsessive-Compulsive Disorder: Atypical antipsychotics significantly helped patients who don’t respond adequately to SSRI therapy, studies showed. Overall, patients taking the drugs were about 2.7 times as likely to improve as patients taking placebo. The chances of benefiting were best for risperidone and quetiapine.

Post-Traumatic Stress Disorder: Studies of men with combat-related PTSD showed risperidone and olanzapine, when used with antidepressants or other psychotropic medications, improved sleep quality, anxiety, and other symptoms. Studies were inconclusive when measuring benefits for women.

Personality Disorders: For patients with borderline personality disorder, one study suggested olanzapine was more effective than placebo but showed little benefit when used to augment talk therapy. All studies of olanzapine were very small, however, and patients experienced significant weight gain. Two other small trials suggested risperidone may benefit patients with schizotypal personality disorder, and aripiprazole may help patients with borderline personality disorder.

Tourette’s Syndrome: Risperidone is more effective than placebo, according to a small body of research. The benefits of ziprasidone are uncertain

Off-label prescribing is a common but relatively understudied practice in health care. A 2001 AHRQ-funded study concluded that about 21 percent of prescribed drug use was for conditions not indicated on the label. Cardiac medications and anticonvulsants were the drugs most commonly used off label. Most off-label use occurs without scientific support, the study said.

Source-Nwswise
SRM
'"/>




Related medicine news :

1. Evidence Links Protein Damage to Neurodegenerative diseases like Parkinsons and Alzheimers
2. Evidence supporting H.pylori eradication
3. Evidence against use of Beta blockers as first choice in the treatment of primary hypertension
4. Evidences that Better Health Care Facility is Offered By Public Hospitals.
5. First Conclusive Evidence Linking Oral Bacteria To Premature Babies
6. Study Provides Evidence That Obesity Leads To A More Aggressive Ovarian Cancer
7. No Clear Evidence for Ultra-Low Cholesterol Targets?
8. Lack of Evidence on Treatment for Narrowed Kidney Arteries
9. Some Evidence Shows Chinese Herbal Medicine Helps Angina Patients
10. Strong Evidence Suggests Incidence Of Mating Of Ancestors With Neanderthals
11. Dermatologists Provide Unique Evidence of Possible Cause of Rare Skin Condition
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:6/26/2016)... ... June 26, 2016 , ... ... have been diagnosed with endometriosis. These women need a treatment plan to not ... comprehensive approach that can help for preservation of fertility and ultimately achieving a ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room ... Dr. Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. ... of our new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of ...
(Date:6/24/2016)... ... 24, 2016 , ... A recent article published June 14 on ... article goes on to state that individuals are now more comfortable seeking to undergo ... such as calf and cheek reduction. The Los Angeles area medical group, Beverly Hills ...
(Date:6/24/2016)... ... ... Global law firm Greenberg Traurig, P.A. announced that 20 Florida attorneys are recognized ... this recognition are considered among the top 2 percent of lawyers practicing within the ... this year’s Legal Elite Hall of Fame: Miami Shareholders Mark D. Bloom, Burt ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB Medicine presented ... in Emergency Medicine conference in Ponte Vedra Beach, FL. The awards honor the ... Emergency Medicine Practice and Pediatric Emergency Medicine Practice. , “With this award, ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 Dehaier Medical ... the "Company"), which develops, markets and sells medical devices ... , signed a strategic cooperation agreement with Hongyuan ... "Hongyuan Supply Chain") on June 20, 2016, to develop ... the strategic cooperation agreement, Dehaier will leverage Hongyuan Supply ...
(Date:6/24/2016)... , June 24, 2016 Research and ... Market for Companion Diagnostic Tests" report to their offering. ... for Companion Diagnostics The World Market for ... personalized medicine diagnostics. Market analysis in the report includes the ... Market (In Vitro Diagnostic Kits) by Region (N. America, EU, ...
(Date:6/24/2016)... 24, 2016   Pulmatrix, Inc ., (NASDAQ: ... inhaled drugs, announced today that it was added to ... its comprehensive set of U.S. and global equity ... an important milestone for Pulmatrix," said Chief Executive Officer ... of our progress in developing drugs for crucial unmet ...
Breaking Medicine Technology: