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Off-label indications for atypical antipsychotics: A systematic review
Konstantinos N Fountoulakis1, Ioannis Nimatoudis, Apostolos Iacovides
13rd Department of Psychiatry, Aristotle University of Thessaloniki Greece. kfount@med.auth.gr
Annals of General Hospital Psychiatry
|February 21, 2004
Summary
Newer atypical antipsychotics like risperidone and olanzapine show potential for treating various mental health conditions beyond psychosis. Further research is needed to confirm their effectiveness as monotherapy or complementary treatments.
Area of Science:
- Psychiatry
- Pharmacology
- Evidence-based Medicine
Background:
- Atypical antipsychotics, including risperidone, olanzapine, and quetiapine, are increasingly considered for conditions beyond psychosis.
- Limited data exists on their off-label use in psychiatric disorders.
Purpose of the Study:
- To review the existing literature on the off-label use of risperidone, olanzapine, and quetiapine.
- To identify potential therapeutic roles in psychiatric disorders other than psychosis, bipolar disorder, and dementia.
Main Methods:
- A comprehensive MEDLINE search was conducted using keywords for risperidone, olanzapine, and quetiapine combined with DSM-IV diagnoses (excluding psychosis, bipolar, and dementia).
- Included studies were assessed using the JADAD index for quality.
- A total of 100 papers were selected for review.
Main Results:
- The review identified 59 papers on risperidone, 37 on olanzapine, and 4 on quetiapine.
- Ten papers (7 risperidone, 3 olanzapine) met a JADAD index threshold of >2, indicating higher quality evidence.
- Preliminary data suggests potential benefits for risperidone in refractory OCD, Pervasive Developmental Disorder, stuttering, and Tourette's syndrome.
- Olanzapine showed promise for refractory depression and borderline personality disorder.
Conclusions:
- Evidence for the off-label use of atypical antipsychotics is currently limited.
- Positive findings suggest that further rigorous research is warranted.
- These agents may offer future therapeutic options as monotherapy or augmentation strategies for a wider range of psychiatric conditions.