Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic.
This study aimed to describe the level of off-label treatment with psychotropic drugs at a child and adolescent psychiatric outpatient clinic in Denmark. We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent psychiatric ward, on 1 day in 2014. Prescriptions of drugs from ATC group N05-N06 were classified according to label status. Six hundred and fifteen drug prescriptions distributed on nine different drugs were prescribed to 503 children eligible for this study. Overall results showed that 170 of the 615 prescriptions were off-label, which corresponds to 27.6 %. Attention deficit hyperkinetic disorder (ADHD) drugs were prescribed 450 times (73.2 %) of which 11 prescriptions were off-label (2.4 %). Other psychotropic drugs comprised 165 (26.8 %) prescriptions and of these 159 (96.4 %) were off-label. With 106 prescriptions, melatonin was the most prescribed of these drugs; all prescriptions were off-label. The main reasons for classifying prescriptions as off-label were age and indication of treatment. This cross-sectional study reveals that medical treatment of children with other psychotropic drugs than ADHD drugs is usually off-label. ADHD drugs were, as the only drug group, primarily prescribed on-label. Although off-label prescription may be rational and even evidence based, the responsibility in case of, e.g. adverse drug reactions is a challenge, and clinical trials in children should be incited.
Department of Biomedicine: Pharmacology and Clinical Pharmacology, Aarhus University Hospital and Aarhus University, Aarhus C, Denmark. esn@biomed.au.dk.
Eva Skovslund
ES
Nielsen
Department of Biomedicine: Pharmacology and Clinical Pharmacology, Aarhus University Hospital and Aarhus University, Aarhus C, Denmark.
Maja
M
Hellfritzsch
Centre of Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
Merete Juul
MJ
Sørensen
Centre of Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
Helle
H
Rasmussen
Centre of Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
Per Hove
PH
Thomsen
Department of Biomedicine: Pharmacology and Clinical Pharmacology, Aarhus University Hospital and Aarhus University, Aarhus C, Denmark.
Torben
T
Laursen
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D056687:Off-Label Use; D010044:Outpatient Clinics, Hospital; D011567:Psychiatric Department, Hospital; D011619:Psychotropic Drugs / Q000627:therapeutic use*
D011619:Psychotropic Drugs
Child and adolescents psychiatry; Children; Medication safety; Off-label; Outpatient clinic; Psychotropic drugs