The effects of antipsychotics in insomnia, anxiety and depression – APSY Oulu project
Approximately 200,000 people in Finland use antipsychotics and about half of them use antipsychotics for some other use than the official indication. This is called off-label use. On-label indications for the use of antipsychotics are psychosis and bipolar disorder, and for some medicines for example aggression in dementia, behavioural problems and adjuvant medication in severe depression. Though for some conditions there is no official indication for the use of antipsychotics, the use may be clinically justified and effective. However, there is an insufficient amount of knowledge about the prescription habits of antipsychotics and about the effects of antipsychotics in off-label use.
The aim of this project is to find out benefits and harmful effects of antipsychotics in non-psychotic conditions such as anxiety, insomnia and depression. The subject will be studied in different Finnish data sets.
Questionnaire for physicians about the prescription habits of antipsychotics
In 2019 we performed a questionnaire study for doctors in different health care organisations in Finland. The purpose of the questionnaire was to find out the physicians’ prescription habits, thoughts and experiences concerning antipsychotics, especially in off label use.
Benefits and harmful effects of quetiapine in anxiety, insomnia and depression in 1-year follow-up
In this part of the study we will investigate whether the use of most frequently used off-label antipsychotic quetiapine will cause changes in participants’ overall health, mental symptoms or cognitive functions. The study will be performed during 2021–2023 and include participants from the city of Oulu and some surrounding municipalities. We invite participants of working age who begin quetiapine for insomnia, anxiety or depression. We will collect the data in collaboration with health care centers, occupational health units, mental health services and different universities.
Benefits and harmful effects of off-label use of antipsychotics in different age groups
By utilising already existing register- and research data we can find out predictors and benefits and harmful effects of off-label use of antipsychotics in working age population and old people. We will use data from the Northern Finland Birth Cohort 1966 and MEDALZ , also from other data sets if new opportunities materialise.
Importance of this project
The use of antipsychotics, especially off-label use, has increased notably during the last decades. Antipsychotics have been studied mainly in clinical settings with a short follow-up and selected population. Our aim is to investigate the long-term use of antipsychotics in different unselected populations. With this project we will find out possible effects of antipsychotics on symptoms, cognition and physical health. Through the study results, and if seen needed, we are able to improve the health care practices.
Methods of the APSY Oulu study and preliminary results from the questionnaire to the doctors and clinical pilot study have been presented in a poster in the 33rd Nordic Congress of Psychiatry 17th–18th June 2021. See the poster here.