Off-Label Use of Atypical Antipsychotics: An Update
Clinically Significant Outcomes of Interest in the Comparative Effectiveness Review (2 of 2)
A variety of validated assessment instruments are used to measure outcomes of treatment with atypical antipsychotics. Remission rates and changes in symptom severity are reported. Response rates are defined as the proportion of participants achieving an a priori-specified degree of improvement on a rating scale.
For personality disorders, either borderline (BPD) or schizotypal, several tools are used, including the Symptom Checklist 90 Revised (SCL-90-R), Clinical Global Impressions–BPD (CGI-BPD), the Hamilton Anxiety Rating Scale (HAM-A), and the Positive and Negative Symptoms Scale (PANSS). Post-traumatic stress disorder (PTSD) is assessed with the Clinician Administered PTSD Scale (CAPS). Substance abuse outcomes assessment tools include the Cocaine Craving Questionnaire (CCQ) and the Addiction Severity Index (ASI). Tourette’s syndrome evaluation includes the symptom-specific Yale Global Tic Severity (YGTS) scale and Clinical Global Impressions–Improvement (CGI-I) scale. For insomnia, sleep quality and time-to-onset are scored.
Keywords: antipsychotics | atypical antipsychotics | off-label | second generation | SCL-90-R | CGI-BPD | HAM-A | HAM-D | MADRS | BPRS | PANSS | CAPS | CCQ | ASI | YGTS | CGI-I | personality disorder | PTSD | post-traumatic stress disorder | substance abuse | Tourette’s | insomnia
- Maglione M, Ruelaz Maher A, Hu J, et al. Off-Label Use of Atypical Antipsychotics: An Update. Comparative Effectiveness Review No. 43 (Prepared by the Southern California RAND Evidence-based Practice Center under Contract No. HHSA 290-2007-10062-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11(12)-EHC087-EF. Available at www.effectivehealthcare.ahrq.gov/offlabelantipsych.cfm.
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