An Survey On Off-Label Use Of Antipsychotic Medications In 907 Inpatieints With The Mental Disorders

Background:With the development of medical service,some new usages of drugs have been slowly explored,and the clinical registration test cycle of drugs is long,and the update of drug instructions lags behind,making off-label drug use is common in medical practice.Literature has shown that off-label drug use is prevalent in anticonvulsants,antipsychotics and antibiotics in foreign countries.However,the off-label drug use is common in antiallergy drugs,digestive system drugs,external drugs,Chinese patent drugs and nervous system drugs in our country.The indications for antipsychotic(AP)drugs approved in China are significantly less than those approved by European and American countries.Objective: By analyzing the way of off-label antipsychotic drug use,to provide the basic data for formulating the expert consensus on off-label drug use in Chinese psychiatric department.Method: By hierarchical cluster sampling,using the self-designed questionnaire to investigate the off-label drug use in 907 inpatients who were discharged from hospital in 2017.The diagnosis of mental disorders are accord with the tenth edition of International Classification of Diseases,ten edition(ICD-10)diagnostic criteria.All data were statistically analyzed on SPSS20.0statistical software.Results: A total of 1362 cases were screened,1068 cases were enrolled,and 294 cases were excluded.A total of 51 psychotropic drugs and 14 antipsychotic drugs were involved.A total of 907 patients(84.9%)were treated with antipsychotics.There 454 inpatients were off label uses,accounting for50.1% of the total number of antipsychotics.The common categories of unlabel use is indication 438(48.3%),population 2(0.2%),dosage 19(2.1%).The top six antipsychotic drugs were olanzapine(533 cases),haloperidol(290 cases),risperidone(255 cases),Quetiapine(172 cases),clozapine(88 cases),aripiprazole(73 cases).Psychiatric diagnosis in the top three in the use of AP are depression disorders,separation or conversion disorders,and brain organic disorders.The main pattern of off-label use for indications in AP is that monotherapy 341(77.9%),two AP polypharmacy 86(19.6%),the common diagnosis in AP polypharmacy is dissociative disorder(34,7.8%).Conclusion: The off label use of antipsychotic drugs in our hospital is widespread,so it is necessary for the government to introduce some policies to promote The drug instructions meet with clinical practice.