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These 14 drugs need more study -- and soon, researchers say

November 25, 2008 | 10:56 am

2ndeffexor

Seroquel. Warfarin. Lexapro. Risperdal. Singulair. Wellbutrin. Zoloft. Effexor. Celebrex. Prinivil. Cymbalta. Desyrel. Zyprexa. Procrit.

The 14 names are so familiar they raise few eyebrows when prescribed -- even when prescribed for uses not approved by the Food and Drug Administration. But perhaps they should.

Among prescription drugs, those medications' effectiveness and safety in off-label treatment are most in need of evaluation, a team of health experts has announced. The drugs are being prescribed, if not willy-nilly, at least without enough proof that they can help -- and not harm, the experts contend.

In a report published in the December issue of Pharmacotherapy, the researchers at the University of Illinois-Chicago, Stanford University and elsewhere explain their selection of the above drugs as the ones most deserving of further study. They considered how often the drugs were prescribed off-label without much evidence, the potential safety problems and the costs.

Off-label prescribing, they know and we know, is rampant. (See When there's little proof a prescription drug will work.) And a recent study pointed out some of the ways in which drug manufacturers encourage doctors to do this. (See Tricks help drug makers sell prescription meds for uses not approved by FDA.)

Of note is the fact that many drugs used off-label are antipsychotics or antidepressants (six on the list are being used to treat bipolar disorder). The researchers expound a bit on that in a press release, which includes a chart of the drugs' approved and nonapproved uses. (For more information about the drugs themselves, try the FDA site or the somewhat more accessible drugs.com.)

Doctors can prescribe whatever they think might help a patient, regardless of whether it's been proven to work. And they do -- especially when they lack good, approved options. But the practice isn't without risks and potential conflicts, hence an increasing effort to get a handle on the issue.

This list could be the beginning.

-- Tami Dennis

Photo: Effexor, approved to treat depression, is among the drugs increasingly used to treat conditions for which they're not approved (in this case, bipolar disorder).

Credit: Joe Raedle / Getty Images

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