Bipolar Today

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Government inspectors in the United States asked lawmakers to help ensure that antipsychotics are not used for the treatment of dementia among elderly patients. Antipsychotics are FDA approved for use in bipolar disorder and schizophrenia, but the inspectors found that hundreds of thousands of elderly patients with dementia are being given antipsychotics to control their symptoms. In addition, antipsychotics can be especially dangerous for elderly with dementia, and many antipsychotics (including most of the modern atypical antipsychotics) specifically warn against their being given to elderly patients with dementia. An inspector from the U.S. Department of Health and Human Services advised the Senate Committee on Aging that it should be penalizing nursing homes for misuse of antipsychotic drugs. More information can be found in this article.

Commentary

This is a somewhat complex issue, and has to do with the prescription of medications for off-label uses generally. When medications are approved by the FDA, they are approved for a single purpose. Once the medication has been approved, however, the medication can be prescribed by physicians for any purpose. This is called using a medication “off label.” Because the medication has already been approved for one use and may be used for any use, pharmaceutical companies generally do not seek approval for additional uses due to cost.

However, pharmaceutical companies are not allowed to market medications for off-label uses, and several companies have faced fines upward of a billion dollars recently for off-label marketing, including the prescription of antipsychotics for dementia among the elderly. So, the issue is fairly complex. On the one hand, physicians are allowed to prescribe medications for off-label uses. On the other hand, much of the overuse of antipsychotics among elderly with dementia seems to be the result of off-label marketing.

Related posts:

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2. Abilify Approved in Canada for Use in Some Teens
3. Atypical Antipsychotics and Diabetes: Dr. Ponder
4. BC Hospital Opens Clinic For Youth Taking Antipsychotics
5. Some Antipsychotics Better For Acute Mania: The Lancet