Off-label use of Atypical Antipsychotics at the Crisis Intervention Unit

Abstract

Objectives:

Antipsychotic medications are registered for the use in psychosis, mania and agitation. the aim of our study was to assess the off-label use of atypical antipsychotics (AA) at the Crisis Intervention Unit (CIU).

Methods:

Hospital records of 280 patients that were treated at the CIU in year 2007 were included to the observational study. Patients were screened for diagnosis (ICD-10), gender, age, suicidal behaviour and for prescribed psychotropic medications. Off-label use of atypical antipsychotics for diagnoses other than psychosis was evaluated.

Results:

Most hospitalised patients suffered for stress related disorders: adjustment disorder F43.2 (34%), acute stress disorder F 43.0 (2%), mixed anxiety-depression disorder F41.2 (19%), depression (24%), anxiety disorders (4%) and other disorders (17%). Patients were treated with antidepressants (92%), benzodiazepines (55%), hypnotics (44%) and mood stabilising drugs (9%) during their stay at the CIU. at discharge from hospital benzodiazepines (31%) and hypnotics (12%) were prescribed in lower percentages. 51% of patients received AA at least once during their stay at the CIU, 49% received AA for off-label use and it was prescribed for most of the hospital stay (for 87% of the time). Average daily CPU at admission to the hospital was 107.52 and at the discharge it was 100.33. No significant differences were noted among the different diagnoses for off-label AA use.

Conclusions:

Atypical antipsychotics are widely used for indications other than psychosis, even though the long-term effects of their use are not yet known and safety issues remain to be examined further.