Haw Camilla, Stubbs Jean
St. Andrew's Healthcare, Billing Road, Northampton, UK.
Expert Opin Drug Saf. 2007 Sep;6(5):533-45. doi: 10.1517/14740338.6.5.533.
The off-label prescribing of antipsychotic drugs to psychiatric patients of all ages is very common. Such off-label use is a necessary part of the art of psychiatry but brings with it increased responsibilities for the prescriber as, if the patient suffered an adverse reaction, liability would rest with the prescriber and/or their employers. This article reviews the frequency and nature of the off-label prescribing of antipsychotic drugs for psychiatric indications to children, adults and the elderly. It also reviews the evidence base for doing so in a variety of common, and also some less common, clinical situations. The review is mainly concerned with off-label indications but a short section on high dose antipsychotics is also included. The review concludes that the off-label prescription of antipsychotics frequently lacks the support of robust clinical trials. When prescribing off-label, the prescriber must carry out a careful risk assessment of the risks and benefits for the individual patient. They should also inform the patient that the prescription is off-label.
向各年龄段的精神科患者超说明书使用抗精神病药物的情况非常普遍。这种超说明书用药是精神病学艺术的必要组成部分，但也给开处方者带来了更多责任，因为如果患者出现不良反应，责任将由开处方者和/或其雇主承担。本文回顾了抗精神病药物用于儿童、成人和老年人精神科适应症的超说明书用药频率和性质。还回顾了在各种常见以及一些不太常见的临床情况下这样做的证据基础。该综述主要关注超说明书适应症，但也包括了一小部分关于高剂量抗精神病药物的内容。综述得出结论，抗精神病药物的超说明书处方常常缺乏有力临床试验的支持。在进行超说明书处方时，开处方者必须对个体患者的风险和益处进行仔细的风险评估。他们还应告知患者该处方属于超说明书用药。
