Atypical Uses of Atypical Antipsychotics

Abstract

Atypical antipsychotic drugs are primarily indicated for the treatment of psychotic disorders such as schizophrenia and schizoaffective disorder. Recently, they have also been used for mood stabilization. This article reviews other, potentially therapeutically useful indications for these medications. In most cases, the evidence supporting these new uses is limited but provocative, and involves only case reports. It has not yet been determined whether the usefulness of atypical antipsychotics for nonpsychotic disorders outweighs their potential to cause serious side effects.

Continuation Rate of Atypical Antipsychotics After Discharge When Initiated in the Intensive Care Unit

“…[1][2][3][4][5] It is estimated that 43% to 70% of atypical antipsychotics are used for off-label indications such as insomnia, anxiety, and posttraumatic stress disorder. 6,7 There is limited evidence for the use of atypical antipsychotics in the intensive care unit (ICU) to treat psychiatric symptoms associated with agitation and psychosis, including delirium. [8][9][10][11][12] One of the trials that showed a potential benefit for the use of these agents in the ICU was conducted by Devlin et al in 2010.…”

Anxiolytic-like property of risperidone and olanzapine as examined in multiple measures of fear in rats

“…Some case reports suggest that clozapine, olanzapine, quetiapine and risperidone improve symptoms of obsessive-compulsive disorder (OCD) and panic disorder, while an equal number of reports indicate the worsening effects of each drug on these disorders (Brooke et al, 2005). For other anxiety disorders, such as post-traumatic stress disorder (PTSD), some studies find that atypicals improve certain symptoms (e.g., hyperarousal and reexperiencing) (Hamner, 1996, Monnelly et al, 2003, Petty et al, 2001), while others failed to reach the same conclusion (Butterfield et al, 2001, Hamner et al, 2003).…”

Clozapine and olanzapine exhibit an intrinsic anxiolytic property in two conditioned fear paradigms: Contrast with haloperidol and chlordiazepoxide

“…The results have been mixed (Carson et al, 2004). Some case reports suggest that atypicals improve symptoms of obsessive-compulsive disorder and panic disorder, while an equal number of reports indicate the worsening effects on these disorders (Brooke et al, 2005). Preclinical evidence is also inconclusive.…”