Atypical antipsychotic drugs are used widely beyond the original group of mental disorders, schizophrenia and bipolar disorder, for which they were initially approved. Authors of a study of prescribing patterns, published in Health Affairs, indicate a steady increase in uses for "conditions for which no FDA indication existed." This includes behavior control for youth and the elderly, and without the benefit of evidence-based indicators.

ADHD without diagnoses for schizophrenia, autism, or bipolar disorder accounted for more than one-third of Medicaid youth receiving antipsychotics in 2004. . . Among youth with externalizing disorders, antipsychotics are often used to control aggressive behavior. Yet few well-controlled clinical trials exist to guide antipsychotic treatment in this population.

The authors expect this trend to continue based on FDA approvals for treatment-resistant depression, and television advertising as well as other direct-to-consumer marketing. Safety concerns remain about the use of these drugs, leading the authors to conclude, " efforts to build the evidence base through a variety of strategies, including randomized-trial and observational methods, are greatly needed."