Despite the fact that antipsychotic drugs are approved by the FDA for specific uses, these drugs really may be prescribed for anything. When a drug is prescribed for something it is not approved or labeled for, this is called “off-label” use. 

Off-label use of anti-psychotics among the elderly is not uncommon. These medications are prescribed to residents who may suffer from Alzheimer’s or dementia, but who do not suffer from psychosis. This is concerning because several antipsychotics frequently prescribed “off-label” can have significant side effects for the elderly, including death. In fact, some of these drugs have received “black box” warning from the FDA – the most severe warning that can be given.

Always of concern to us is when medications are given solely for the convenience of the nursing home. In these cases, medications are given simply to make residents quiet and immobile. You see this in cases where staffing is cut to minimum levels and there are not enough people to adequately supervise the resident population.   

A new law has been proposed in an attempt to curb off-label use of powerful antipsychotics. The new law “will require the Health and Human Services Secretary to issue standardized protocols for obtaining informed consent, or authorization from patients or their designated health care agents or legal representatives, acknowledging possible risks and side effects associated with the antipsychotic, as well as alternative treatment options, before administering the drug for off-label use.” 

You can read the full article here, which includes a link to the amendment.