High Cost to Medicaid Programs For Off-Label Use of Antipsychotics


A study of 42 state Medicaid programs found that 58% of prescriptions for antipsychotics  were not for schizophrenia or bipolar disorder. Off-label prescribing was most prevalent among individuals under 21 years of age (76%) or over 65 (65%), as opposed to 49% for those between 21 and 64 years. The authors note that the medications are expensive and have limited evidence of effectiveness. Results are published in this month’s American Journal of Managed Care.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].