Off-Label Use of Antidepressant, Anticonvulsant, and Antipsychotic Medications Among Georgia Medicaid Enrollees in 2001.
J Clin Psychiatry 2006;67(6):972-982
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objectives: To determine the prevalence
of and factors associated with the off-label use
of antidepressant, anticonvulsant, and
Method: A retrospective analysis of
Georgia Medicaid recipients was conducted.
Recipients prescribed antidepressant, anticonvulsant, or
antipsychotic medications were identified.
Logistic regression analysis was used to identify
factors associated with off-label use.
Results: A total of 46,976 (75.42%)
antidepressant recipients, 38,497 (80.12%)
anticonvulsant recipients, and 21,252 (63.62%)
antipsychotic recipients received at least 1 of
these medications off-label in 2001. The likelihood
of receiving off-label medications increased
remarkably with advancing age (> = 65 vs. < 65
years: antidepressant: OR = 5.15, 95% CI = 4.76 to
5.56; anticonvulsant: OR = 4.54, 95% CI = 4.16 to
4.96; antipsychotic: OR = 5.21, 95% CI = 4.82 to
5.63). Although receiving new anticonvulsants
launched after 1993 was the strongest predictor
(OR = 7.63, 95% CI = 7.07 to 8.23) of receiving off-label
anticonvulsant medications, exposure to newer antidepressants and antipsychotics did not confer
a higher chance of receiving off-label medications (selective serotonin reuptake inhibitors vs.
tricyclic antidepressants: OR = 0.43, 95% CI = 0.40 to 0.45; atypical vs. conventional antipsychotics: OR = 0.76, 95% CI = 0.72 to 0.80).
Conclusions: The off-label use of
antidepressant, anticonvulsant, and antipsychotic
medications is highly prevalent. Further research
to study the effects of off-label use among this
high risk subpopulation may be an important step
toward defining the scope of and potential for