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Off‐Label Prescribing by Psychiatrists: What is the Practitioner's Liability?
Author(s) -
Bartoli Christophe,
BerlandBenhaim Caroline,
Sastre Caroline,
BaillifCouniou Valerie,
Kintz Pascal,
Leonetti Georges,
PelissierAlicot AnneLaure
Publication year - 2015
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.12814
Subject(s) - medicine , off label use , context (archaeology) , liability , medical emergency , psychiatry , authorization , family medicine , adverse effect , business , pharmacology , computer security , paleontology , computer science , biology , finance
Abstract In psychiatry, the molecules available and the dosages recommended when a drug receives marketing authorization are not always adequate to treat patients with major behavioral disturbances. Off‐label prescribing is frequent in this context, with regard to the indications and the dosages given as well as to the drug combinations used. However, if complications or death occur, the practitioner's liability may be engaged. The authors report three deaths attributed to off‐label prescribing in psychiatry and which led to charges against the physicians. They review the precautions to be taken when prescribing in such conditions (no other possible treatment, existence of sound scientific evidence, consent obtained from the patient, or their legal representatives except in cases of force majeure) and the physician's liability if adverse events occur that could be attributed to off‐label prescribing.