Off-Label Antidepressants Common; Evidence Lacking

By Alan Mozes

HealthDay Reporter

WEDNESDAY, Feb. 22, 2017 (HealthDay News) — Doctors often prescribe antidepressants to tackle conditions like migraine headaches for which they aren’t technically approved. Now, researchers say such “off-label” usage mostly occurs without clear scientific evidence backing up the treatments.

A new Canadian study found that almost one-third of antidepressants are prescribed for pain, insomnia, migraine or other unapproved uses.

But just 16 percent of those off-label prescriptions were found to be supported by strong research.

Study lead author Jenna Wong described the findings as “eye-opening” but in line with the findings of prior investigations.

Wong, a doctoral candidate in epidemiology, biostatistics, and occupational health at McGill University in Montreal, said she hopes the findings raise awareness among doctors.

“Some physicians may not be aware that certain off-label antidepressant uses are not evidence-based, especially if the broader community of physicians prescribes antidepressants for these off-label uses so frequently that it seems like the norm,” she said.

Doctors prescribe off-label for other reasons as well.

In cases where the approved medication carries major side effects — such as insomnia drugs for older patients — “physicians may prescribe antidepressants instead of thinking that these drugs are safer,” Wong said.

The new findings stem from an analysis of more than 100,000 antidepressant prescriptions issued in Quebec, Canada, between 2003 and 2015. They were written by 174 Quebec doctors.

According to the study, trazodone was the most common off-label use for antidepressants. It’s often prescribed to help people sleep.

In terms of class of drugs, tricyclic antidepressants like amitriptyline were the most likely to be prescribed off-label. This is a common migraine…

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