DDS MEDICAL ADVISORY #91-2

(Revised #86-1)
UNLABELED USE OF MEDICATIONS FOR THEIR
BEHAVIOR MODIFYING EFFECTS FOR DDS CLIENTS
December 1999

Guidelines for Interdisciplinary Teams and
Program Review Committees

PURPOSE:

The intent of this advisory is to ensure that appropriate reviews occur when a treatment plan includes the unlabeled use of a medication for its psychotropic or behavior modifying effects.

APPLICABILITY:

This advisory applies to all individual who receive supports and services from the department regardless of the facility or region in which they are served.

The department recognizes the special need to work with facilities which it does not fund or license to ensure the thorough understanding and implementation of medical advisories.

DEFINITION:

Unlabeled Use of a Medication: 

A medication prescribed for a use other than that originally indicated and approved by the Federal Drug Administration, for example, Tegretol is approved for use as an anticonvulsive medication, but it is often prescribed as a behavior modifying medication.

PROCEDURE:

When a plan for the unlabeled use of a medication for its psychotropic or behavior modifying effect is submitted to a regional Program Review Committee (PRC), the following information should accompany the plan:

  1. Literature on the specific medication and its unlabeled use if this information has not previously been submitted to the PRC. This literature should contain valid data substantiating the efficacy of the unlabeled use and would include reviews and recommendations concerning the appropriate use as a psychotropic medication in:
    1. nationally recognized psychiatric and neuroleptic journals;
    2. statements by the American Psychiatric Association and other nationally recognized organizations such as the National Association of the Dually Diagnosed;
    3. psychiatry, neurology, and psychopharmacology text books, educational manuals, newsletters and reviews

    This literature shall be maintained in a resource file by the local PRCs.

  2. If the presenting interdisciplinary team confirms that the current literature for this specific medication and proposed us is on file with the local PRC, only the items listed below are required:
    1. the physician's rationale for the use of this specific medication for the individual; and
    2. appropriate informed consent.