Off-label use of antipsychotics in the community pharmacy: the sex differences.

Antipsychotic drugs are generally registered for treating schizophrenia, psychosis, mania, and conditions of severe (locomotor) agitation. In common practice, however, they are prescribed in a wide range of different psychiatric disorders. We conducted a retrospective, exploratory study to examine off-label use of antipsychotics and possibly sex differences. We defined antipsychotic use as quasi-label when used in non-registered disorders that have psychosis as an inherent co-morbidity. When antipsychotics were prescribed in disorders that are generally not known with psychosis, we defined this as off-label use. In this study, we combined pharmacy records with data from general practitioners in order to evaluate the range of diagnoses for which antipsychotic drugs are used. We focused on sex differences in type of disorder and in prescribed dosages of antipsychotic drugs. Among 97 male and 95 female antipsychotic users, we could classify women significantly more often as on-label antipsychotic drug users compared with men. Most often, this occurred with typical antipsychotic drug treatment. While female patients used equal dosages for on-label and quasi-/off-label indications, we found that male patients used significantly lower dosages in quasi-/off-label indications compared with on-label indications. We suggest elaborate future research on the characteristics of quasi- and off-label antipsychotic drug use in order to define effective and safe use of antipsychotic drugs among off-label indications.

Remarks on the structure-activity relationship of silver sulfanilamides.

The biological activity of a series of 10 silver sulfanilamides is studied in relation to the physical parameters pK alpha, log K, and the aqueous solubility. None of the parameters demonstrate a simple relationship with the activity. A discussion of the significance of log K and the solubility in relation to the activity is given.

Microcomputer-controlled determination of dissociation constants of sulfanilamides and stability constants of the related silver complexes.

As a contribution to the structure-activity relationship of silver sulfanilamide complexes, the pKa-values of thirteen sulfanilamides and the log K-values of their related silver compounds were determined using a microcomputer-controlled titrator which determines the silver ion concentration and hydrogen ion concentration in a combined measurement. Predictions on antibacterial effectiveness and the risk of sensitization reactions of some of the investigated silver sulfanilamides are made on the basis of the conditional stability constants computed from the pKa- and log K-values at pH = 7.4.