High Off-Label Use Of Antipsychotics For Depression In VA System
A new study in the Journal of Clinical Psychiatry identifies that many thousands of veterans in the VA system are being given antipsychotics for the treatment of depression, a finding that is startling and unsettling. CL Psych had some thoughts on all of this the other day.
From the study:
“RESULTS: Altogether, 20.6% of veterans with MDD received antipsychotic medications, and 43% of those who did received them at the higher doses recommended for schizophrenia. GEE models showed that younger age, male gender, psychiatric comorbidities, duration of diagnosed MDD, and more intensive mental health service use were all associated with greater likelihood of receiving antipsychotics and with less likelihood of receiving them at conventional antipsychotic doses.
“CONCLUSION: Antipsychotic medications were commonly used in the treatment of MDD prior to FDA approval, especially in the presence of comorbid mental illness and longer term MDD. Further research is needed to evaluate the long-term safety and efficacy of these medications in combination with antidepressants.”
Keep in mind this study covered people in the VA system in 2007 and the most widely used antipsychotic for depression within the VA system was Seroquel. But Seroquel isn’t approved for treating depression (it is approved for bipolar depression), so this is a very high level of off-label use by the VA and sure makes me curious if there’s been any off-label marketing going on by AstraZeneca, which was dinged by the FDA last December for off-label marketing of Seroquel for depression, or what circumstances led the VA to adopt Seroquel and other antipsychotics for use in depression when the available evidence suggests that these drugs are neither particularly safe or efficacious in treating depression.
In other words, I smell a rat.
Related posts:
- 60 Percent Of Antipsychotic Use In VA Off-Label
- The High Price of Sanity: What Antipsychotics Cost
- Study: Lilly Marketed Zyprexa Off-Label For Bipolar Disorder
- Study Uses Deception To Claim Antipsychotics Are Awesome Depression Treatments
- Suspicious Antipsychotics For Depression Study Comes Into Question
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