Off-label Uses of Second-generation Antipsychotic Drugs

Abstract

Pharmacotherapy in the area of psychiatry has continued to rapidly evolve as we gain a greater understanding of psychopathology in various mental illnesses. Since the advent of the second-generation antipsychotic (SGA) or atypical antipsychotic drugs, they have largely replaced the use of its first generation predecessors in the treatment of schizophrenia. This change is primarily attributed to the benefit that SGAs do not carry as high a risk in causing detrimental extrapyramidal adverse effects. These SGAs have not only proven to be efficacious in the treatment of schizophrenia, but their benefit has also been investigated and some SGAs recognized by the U.S. Food and Drug Administration (FDA) for use in the treatment of bipolar disorder, autism, and major depressive disorder (MDD). The discovery by scientists and clinicians of the versatility of SGA treatment in various psychiatric disorders has prompted a call for further research in such disorders. Many clinicians currently use SGAs in an off-label manner with the belief of sufficient evidence to suggest efficacy and favorable tolerability. In addition to similar SGA off-label use in bipolar disorder, autism, and major depressive disorder, the greatest evidence for off-label use of SGAs currently lies in the treatment of Tourette's syndrome, posttraumatic stress disorder, attention deficit hyperactivity disorder-associated aggression, generalized anxiety disorder, stuttering, and potentially obsessive-compulsive disorder. This overview provides clinicians with a summary of current status of information in regards to the FDA-approved and off-label uses of SGAs in conditions other than schizophrenia, bipolar disorder, autism, and MDD.