University of Oulu

Pentinlehto, J., Haapea, M., Ylitolonen, L., Alakokkare, A-E., Niemelä, S., Miettunen, J., Penttilä, M., Koponen, H., Seppälä, J., Isohanni, M., Rautio, N., & Jääskeläinen, E. (2021). Off-label prescribing of antipsychotics - a questionnaire survey of Finnish physicians. Psychiatria Fennica, 52, 22-48.

Off-label prescribing of antipsychotics : a questionnaire survey of Finnish physicians

Saved in:
Author: Pentinlehto, Jami1; Haapea, Marianne1,2,3; Ylitolonen, Lotta1;
Organizations: 1Center for Life Course Health Research, University of Oulu, Finland
2Department of Psychiatry, Oulu University Hospital, Oulu, Finland
3Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
4Department of Psychiatry, University of Turku, Turku, Finland
5Addiction Psychiatry Unit, Turku University Hospital, Turku, Finland
6Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
7Department of Mental and Substance Use Disorders, South Karelia Social and Health Care District, Lappeenranta, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.1 MB)
Persistent link:
Language: English
Published: Psykiatrian Tutkimussäätiö, 2021
Publish Date: 2022-03-28


Antipsychotics (APs), especially second-generation antipsychotics, are being increasingly used around the world. At the same time their off-label use has also increased worldwide, as well as in Finland. The aim of our study was to find out the off-label prescribing of APs in Finland among physicians in different healthcare units. The study was conducted as a questionnaire survey. Particular attention was paid to practices between psychiatrists and other physicians (mostly general practitioners and occupational health doctors). Similar studies have not been conducted on this topic in Finland before. Altogether 216 physicians answered the questionnaire. The most common indications for off-label prescription were insomnia and anxiety, and this was evident for both psychiatrists as well as other physicians. Quetiapine was the one most commonly prescribed off-label AP. Over one-third of psychiatrists (39%) and about one-third of other physicians (30%) did not give instructions on the length of the treatment. The metabolic values were reported to be followed by 44% of the psychiatrists and by 18% of other physicians. Nearly two-thirds of all respondents thought that off-label use had more benefits than harms. Compared to other physicians, psychiatrists prescribed APs for off-label use more frequently and for more varied psychiatric conditions. Off-label use of APs seems to be a clinical reality in Finland. There is need for further studies on efficacy and adverse effects of APs in off-label use, and also a need for clinical guidelines on monitoring the patients using APs off-label.

see all

Series: Psychiatria Fennica
ISSN: 2489-6152
ISSN-E: 2489-6152
ISSN-L: 2489-6152
Volume: 52
Pages: 22 - 48
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: This work was supported by grants from the Academy of Finland (grant number 316563), and Oulu University Hospital funding (basic government funding for hospitals).
Academy of Finland Grant Number: 316563
Detailed Information: 316563 (Academy of Finland Funding decision)
Copyright information: © The Author(s) 2021. Psychiatria Fennica uses an open access policy with an open license (Creative Commons) allowing for immediate free access to the work and permitting any user to read, download, copy, distribute, print, search, or link to the full texts of articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose.