Prescribing Off Label Is Common

Donepezil (Aricept) is approved by the FDA for Alzheimer's disease, and not for the treatment of mild memory loss. So what on earth was I doing prescribing this medication to Diane Pozniak, who had very mild memory loss by any definition, someone who clearly did not have any signs of dementia or Alzheimer's disease? The answer to this seemingly loaded question is quite straightforward. Although the FDA "labels" the use of a medication only for a specific disease or diseases, all licensed physicians are free to prescribe approved medications for other conditions if they wish to do so. Obviously, if something goes wrong and a lawsuit ensues, the physician will have a tough time explaining off-label prescribing in court. In reality, many physicians, particularly psychiatrists and neurologists, prescribe medications off-label. This is because there is a wide gap between patients' needs and what the FDA has been willing to approve for a variety of brain disorders.

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