( ations. Overall however researc...)No Evidence to Support Many Off-label Uses of Atypical Antipsychotics,Health

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
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