title: Off-Label Prescribing of Antipsychotics in Adults, Children and Elderly Individuals: A Systematic Review of Recent Prescription Trends.
abstract: BACKGROUND
  New antipsychotics continuously arrive on the market, which thereby influences the approved and off-label prescribing (OLP) schemes. We aimed to identify the recent trends in the OLP of antipsychotics. We conducted a literature review based on three different populations: adult, pediatric, and elderly patients.
  
  
  METHODS
  A literature search was performed in the PubMed and ScienceDirect databases using the following keyword algorithm: "offlabel" AND ("antipsychotic*" OR "neuroleptic*"). The period investigated ranged from January 2000 to January 2015. Only Englishwritten pharmacoepidemiological studies were included.
  
  
  RESULTS
  Seventy-seven relevant results were identified. Among adults, OLP consisted of 40 to 75% of all antipsychotic prescriptions. The main indications were mood disorders, anxiety disorders, insomnia and agitation. Quetiapine was the most frequently prescribed offlabel antipsychotic, especially for anxiety and insomnia. Among children, OLP was estimated between 36 and 93.2% of all antipsychotic prescriptions. Risperidone and aripiprazole were primarily used and were most often prescribed for attention deficit hyperactivity disorder, anxiety, or mood disorders. Among elderly individuals, OLP consisted of 22 to 86% of all antipsychotic prescriptions. Antipsychotic OLP was particularly frequent for agitation; however, a recent decrease in this OLP was identified.
  
  
  CONCLUSIONS
  Antipsychotics have largely been prescribed off-label in recent years. The types of antipsychotic OLP practices differ according to the age category of patients. OLP is often used in cases of therapeutic dead-ends or for specific disorders with few or no currently approved medications. However, other OLP practices only reflect temporary prescription trends for mild symptoms, which may induce safety concerns.
authors.affiliation: Laboratoire de Pharmacologie, INSERM U1171, Univ Lille, F-59045 Lille, France, 1 place de Verdun, 59045 Lille Cedex. louisecarton85@gmail.com.
authors.forename: Louise
authors.initials: L
authors.lastname: Carton
authors.forename: Olivier
authors.initials: O
authors.lastname: Cottencin
authors.forename: Maryse
authors.initials: M
authors.lastname: Lapeyre-Mestre
authors.forename: Pierre A
authors.initials: PA
authors.lastname: Geoffroy
authors.forename: Jonathan
authors.initials: J
authors.lastname: Favre
authors.forename: Nicolas
authors.initials: N
authors.lastname: Simon
authors.forename: Regis
authors.initials: R
authors.lastname: Bordet
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rolland
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D011307:Drug Prescriptions; D006801:Humans; D057970:Inappropriate Prescribing / Q000639:trends; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D056687:Off-Label Use; D061214:Patient Safety; D010818:Practice Patterns, Physicians' / Q000639:trends*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents