[Off-label psychopharmacological prescription in thirteen forensic outpatient clinics]

Outpatient forensic treatment is generally more focused on diminishing transgressive behavior, rather than the treatment of a specific disorder. However, the indications for prescribing psychotropic medication are usually a specific disorder. Although guidelines are used a large portion of psychopharmacological prescription is off-label.

To explore the extent of off-label prescribing. The study aimed to address three main questions: What is the percentage of off-label prescribing? Which part of off-label prescribing is based on guidelines and formularies? What is the frequency of pharmacist consultation before prescribing off-label medication?

Data for the study were collected by 17 psychiatrists working in the thirteen forensic outpatient clinics of de Waag. The study focused on a sample of 202 adult patients, who were treated between October 2022 and May 2023.

72.0% of 350 prescriptions were prescribed off-label. From these 72.0%, 51.4% was based on guidelines and formularies and 20.6% not. In 84,7% off the off-label prescription not based on guidelines and formularies a pharmacist wasn’t consulted.

This study confirms the high percentage of off-label prescriptions in the forensic psychiatry. However, more than 70% was based on guidelines and formularies.