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:5/27/2016)... ... 27, 2016 , ... More than a third of American adults are considered ... surgery has received increased attention in recent years, as an article published ... weight loss, most people are familiar with the basic requirements of maintaining a healthy ...
(Date:5/27/2016)... York, NY (PRWEB) , ... May 27, 2016 , ... ... campaign returns for a third time to shed lights on the variety of topics ... and inspirational stories, “Nurse Appreciation” tackles why this career has gone from being in ...
(Date:5/27/2016)... ... May 27, 2016 , ... In ... the many who are unaware of the plight of aphasia. In collaboration with ... the “Stroke Awareness” campaign. , The link between stroke and aphasia is relatively ...
(Date:5/27/2016)... (PRWEB) , ... May 27, 2016 , ... ... in scholarships to students studying complementary medicine. Allison Outerbridge is this year’s ... her award on May 18 at the university’s Student Leadership Awards ceremony. , ...
(Date:5/26/2016)... , ... May 26, 2016 , ... W.S. Badger ... has been honored with a 2016 When Work Works Award for its use of ... of the national When Work Works project administered by the Families and Work Institute ...
Breaking Medicine News(10 mins):
(Date:5/24/2016)...   , Study met ... bowel cleansing and superiority in , ... of the ascending colon   ... Norgine B.V. today announced new positive data from the phase ... preparation) versus standard 2 litre PEG with ascorbate. The study met ...
(Date:5/24/2016)... May 24, 2016  NxStage Medical, Inc. (Nasdaq: ... on advancing renal care, today announced that Jeffrey ... in the following schedule of investor conferences. Where applicable, ... at http://ir.nxstage.com/ .   ... Conference NY, NY           Friday, June 10, 2016 1:30 ...
(Date:5/24/2016)... HONG KONG , May 24, 2016 ... , the world , s ... and AV fistula intervention   OrbusNeich, a ... solutions, has expanded its portfolio to include products to ... balloons are the company,s first entry devices for lower ...
Breaking Medicine Technology: