Consumers Digest asked 13 medical experts to determine which medications that are prescribed for off-label use are the most important for consumers to avoid because of potentially dangerous side effects or because no evidence exists to supports off-label use. Although many other unnecessary off-label prescriptions exist, we believe that these medications represent examples that you most likely will encounter.
Divalproex sodium (Depakote)
FDA-approved use: Seizures, bipolar disorder and migraine headaches
Off-label concerns: You should avoid use if it’s prescribed to control agitation and aggression in older patients who have dementia or if it’s prescribed to treat schizophrenia.
FDA-approved use: Hypothyroidism
Off-label concerns: You should avoid use if it’s prescribed for weight loss, because it can cause hyperthyroidism (too much thyroid hormone) and is associated with bone loss and heart arrhythmia.
Liothyronine sodium (Cytomel)
FDA-approved use: Underactive thyroid and some types of goiters
Off-label concerns: You should avoid it as a treatment for depression and weight loss, because it can cause heart problems.
FDA-approved use: Seizures and post-shingles nerve pain
Off-label concerns: You should avoid use if it’s prescribed to treat bipolar disorder, peripheral neuropathy in diabetics and migraines.
Paroxetine hydrochloride (Paxil)
FDA-approved use: Adult depression
Off-label concerns: You should avoid use for treatment of depression for children and teenagers, because it can increase the risk of suicidal thinking in patients who are under 18.
FDA-approved use: Epilepsy and migraines, as well as weight loss (when it’s used in combination with phentermine)
Off-label concerns: You should avoid use for psychiatric disorders, but its use is acceptable to reduce alcohol cravings in alcoholics.