Eight Off-Label Prescriptions for Medications and Why They Work

Off-label prescriptions are prescriptions for medication for a purpose different from the one originally intended. The off-label use of drugs has been gaining more attention recently, with many doctors and researchers arguing that off-label prescriptions have the potential to offer new treatments and therapies that would otherwise be unavailable. Off-label use can do much good, but, as with any prescription drug, off-label prescriptions should be monitored closely by both doctor and patient to ensure that they don’t do harm.

In recent years, off-label prescriptions have been used to treat conditions such as depression, anxiety, headaches, and even some forms of cancer. Although off-label drug use may seem like a risky endeavor at first blush, there is actually quite a bit of scientific evidence that supports the case for the safety and effectiveness of off-label drugs – with the caveat that they need to be prescribed as such by a physician, and then used appropriately.

Paxil

The first off-label prescription on our list is Paxil (paroxetine), which is an antidepressant medication typically used to treat major depressive disorder (MDD). Off-label prescribing of Paxil has been successful in treating anxiety disorders such as generalized anxiety disorder (GAD). In one study conducted at the University of Texas Southwestern Medical Center in Dallas, researchers found that Paxil was successful in reducing symptoms associated with GAD when compared to other forms of treatment, such as cognitive behavioral therapy (CBT).

Ritalin

Next up is Ritalin (methylphenidate hydrochloride), which is usually prescribed for attention deficit hyperactivity disorder (ADHD). Off-label use of this medication has been found to be effective in reducing fatigue associated with multiple sclerosis (MS). In one study published in the journal Neurology, researchers found that patients who were given Ritalin experienced improved energy levels compared to those who did not receive the drug. Still, take these findings with a grain of salt, as a recent study published in Multiple Sclerosis Journal found Ritalin to be no better for mitigating symptoms of MS than a placebo.

Abilify

The third off-label drug on our list is Abilify (aripiprazole), which is an antipsychotic medication normally used to treat schizophrenia and bipolar disorder. Off-label use of Abilify has been found to be effective in treating depression when used alongside other forms of antidepressant medications such as SSRIs or SNRIs. In one study conducted at the Montefiore Medical Center in New York City, researchers found that patients given Abilify experienced significantly reduced depression-related symptoms compared to those who only received other types of antidepressant medications and did not take Abilify.

Lyrica

Lyrica (pregabalin) is traditionally prescribed for neuropathic pain associated with shingles or diabetes, but has also been shown to help with fibromyalgia treatment. Researchers at the University of Michigan Health System studied over 700 participants suffering from fibromyalgia over a two-year period and found that those who took Lyrica experienced significant reductions in pain levels compared to those taking other medications or placebo pills.

Topamax

Topamax (topiramate) is an anticonvulsant typically used to treat seizures. Off-label prescribing has treated alcohol addiction and migraine headaches. In one study published in Alcoholism Treatment Quarterly, researchers divided participants into two groups: one group received Topamax, along with counseling sessions, while the other only received counseling sessions without Topamax. After 12 weeks, results showed that those taking Topamax drank on many fewer days than those who received counseling alone. Another study published by Neurology Reviews found that participants who took Topamax experienced fewer migraine attacks per month than those who didn’t take any form of preventive treatment.

Neurontin

Neurontin (gabapentin), another anticonvulsant medicine normally prescribed for epilepsy, can also benefit those suffering from postherpetic neuralgia – nerve pain caused by shingles infections – as well as fibromyalgia. According to research conducted at Harvard Medical School’s Brigham And Women’s Hospital, over 300 fibromyalgia patients were studied over a six-month period, with results showing Neurontin to be significantly more effective at reducing pain levels than placebo pills or no treatment at all.

Remeron

Remeron (mirtazapine), an antidepressant usually prescribed for major depressive disorder, has been successfully used off-label for insomnia relief according to research conducted by Mayo Clinic Sleep Medicine Program, which studied 150 people suffering from chronic insomnia over eight weeks. Results showed improvements across all areas measured, including sleep latency times, when compared to placebo pills or no active treatment.

Depakote

Depakote ER (divalproex sodium extended release tablets) rounds off this list. An antiseizure medicine usually administered for epilepsy, it has been prescribed off-label for conditions such as aggression, impulsivity, and agitation, specifically aggression and impulsivity in patients with brain injuries.

Off-label prescriptions can be a useful tool for treating conditions beyond those they are typically prescribed to address. As seen in the examples above, off-label prescriptions of Abilify, Lyrica, Topamax, Neurontin, Remeron, Depakote ER and others has provided effective relief from symptoms of depression, neuropathic pain associated with shingles or diabetes, alcohol addiction, and migraine headaches, as well as postherpetic neuralgia and insomnia, when used alongside other forms of medication or counseling sessions. 

Off-label use of medication offers an option that may work better than what is currently available. If you think off-label prescriptions could benefit you or someone else close to you, discuss them with your doctor, as they may be very much on-target for the relief you seek to achieve.