Atypical Antipsychotics Often Prescribed Despite Uncertain Evidence, Study Shows

According to a new study, despite the massive advertising campaigns, there is a lack of evidence for the generalized and widespread use of atypical antipsychotic medications, such as Abilify, Seroquel, and Risperdal. The research was conducted by researchers at Stanford University School of Medicine and the University of Chicago.

Atypical antipsychotics have become so widely used that, according to the researchers, the use of these medications has surpassed the use of older antidepressants and other psychiatric medications over the past ten years. Antipsychotics are approved by the United States Food and Drug Administration (FDA) for the treatment of schizophrenia, other types of psychotic disorders, aspects of bipolar disorder, and depression. However, many doctors also utilize these medications to treat individuals with other psychiatric illnesses such as insomnia, anxiety, and dementia. When this happens, the physician is using the drug for an "off label," purpose, which is legal.

While atypical antipsychotic were originally thought to have few side effects, follow-up research has shown these medications contain some dangerous risks. For instance, according to the National Institute of Health, you may experience unexpected changes in your mental health while taking quatrain (Seroquel). These changes may include having panic attacks, new or worsening depression, having suicidal thoughts or actions, excessive worry, aggressiveness, impulsivity, sleep difficulties, severe restlessness, agitation, irritability, and/or abnormal feelings of excitement. Additionally, quatrain can lead to hyperglycemia and to diabetes. Excessive weight gain, stomach pain or swelling, joint pain, drowsiness, thinking and concentration difficulties, breast discharge, breast enlargement in males, lack of coordination, cataracts, vision changes, seizures, uncontrollable muscle movements, rapid or irregular heartbeat, fainting, and urination difficulties are some of the other side effects one may experience while taking this medication.

In order to discover how much atypical antipsychotics are being prescribed and for which conditions, the researchers examined data from the IMS Health National Database and Therapeutic Index survey, which is conducted by IMS, a healthcare information company. Approximately 1,800 doctors take part in the survey during every calendar quarter, each providing two days worth of data, which has been randomly assigned to them. The survey examines the conditions physicians treated as well as the medications they prescribed for them.

The researchers discovered atypical antipsychotic prescriptions nearly tripled from 1995 to 2008. Specifically, 6.2 million prescriptions for atypical antipsychotic were given in 1995 whereas 16.7 million were given in 2008. In addition, the number of prescriptions for first-generation antipsychotics decreased from 5.2 million to one million. Whereas 4.4 million antipsychotic prescriptions were written for conditions not approved for treatment with these medications by the FDA in 1995, nine million antipsychotic prescriptions were written for such conditions in 2008.

The researchers also assessed the strength of the evidence for utilizing antipsychotics for purposes not approved by the Food and Drug Administration. They did this by utilizing efficacy results from the drug compendium, Drugdex.

The researchers discovered that 54% of the prescriptions given for atypical antipsychotic medications in the year 2008 had uncertain evidence that they would be beneficial to the patient. Furthermore, in 2008 $6 billion was spent on atypical antipsychotic medications for off-label uses of which $5.4 billion was spent on atypical antipsychotics without certain evidence of their benefits.

Finally, while atypical antipsychotic prescriptions decreased slightly after the FDA issued safety warnings in 2005 for them, their use has steadily risen since they first came onto the market in the year 1989. These medications have largely replaced first-generation antipsychotics.

While doctors may prescribe patients antipsychotic medications for mental illnesses, I encourage you to do your research before you take any medication. Please talk to your doctor about the risks and benefit's the medication will have for your specific situation and get all of the information you need about side effects and possible medication interactions before you make a decision with your doctor about whether an antipsychotic medication is right for you. Open communication is key to informed decision making about medication by both doctor and patient.

If you would like more information about the research study described in this article, please visit the January 7 on-line edition of the journal Pharmacoepidemiology and Drug Safety where the research was published.

Source:

Pub Med Health: U.S. National Library of Medicine: National Institute of Health: Quetiapine:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001030

Psych Central: Evidence for Atypical Antipsychotic Drugs Called Into Question:
http://psychcentral.com/news/2011/01/07/atypical-antipsychotic-medication-evidence-called-into-question/22419.html