{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T03:44:24Z","timestamp":1776397464183,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to assess the use of psychotropic drugs in children and adolescents and their off\u2010label use in clinical settings across multiple hospitals in China, as well as to further analyze the influencing factors of off\u2010label use and evidence\u2010based medical evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multi\u2010center retrospective cross\u2010sectional investigation was conducted in secondary and tertiary public hospitals. The study collected prescriptions for patients under 18\u2009years old, which contained psychotropic drugs, including antidepressants, antianxiety drugs, antipsychotics, mood stabilizers, and psychostimulants. Evidence for the prescription was determined by the clinical practice guidelines and Thomson Grades in the Micromedex. Logistic regression analysis was used to explore the influencing factors of off\u2010label use of psychotropic drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1261 medical records involving 34 kinds of psychotropic drugs for 813 children and adolescent patients were identified. Among them, off\u2010label medical records accounted for 74.2% (936 medical orders), and the three most\u2010used off\u2010label drugs include fluvoxamine, tandospirone, and sertraline. Among patients with off\u2010label drug use, the incidence was significantly higher in females than in males, while the incidence in adolescents (12\u201317\u2009years old) was significantly higher than that in children (2\u201311\u2009years old) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The types of off\u2010label drug use among all the included psychotropic drugs were mainly over\u2010age (45.9%) and unapproved indication use (36.2%). Multiple logistic regression revealed that female (OR\u2009=\u20091.134, 95% CI [1.027, 1.749],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031) and adolescent (OR\u2009=\u20092.520, 95% CI [1.181, 5.374],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017) were related to a higher risk of off\u2010label use of psychotropic drugs when compared to male and children, respectively. Twenty\u2010one kinds (61.8%) of off\u2010label drug types were identified, among which 15 kinds of psychotropic drug use were not supported by evidence\u2010based medical evidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Off\u2010label use of psychotropic drugs is highly prevalent in children and adolescents. The use of psychotropic drugs should be based on instructions and evidence\u2010based medical evidence to ensure their rational use in these patient populations. The drug administration should standardize the practice of pediatric prescription in the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70340","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T09:01:03Z","timestamp":1772960463000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Off\u2010Label Psychotropic Drug Use in Children and Adolescents: A Multi\u2010Center Cross\u2010Sectional Study in China"],"prefix":"10.1002","volume":"35","author":[{"given":"Yue\u2010Peng","family":"Teng","sequence":"first","affiliation":[{"name":"Department of Pharmacy The Second People's Hospital of Lanzhou  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cai\u2010Dong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy The Second People's Hospital of Lanzhou  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen\u2010Juan","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Gansu Provincial Hospital  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Wu","sequence":"additional","affiliation":[{"name":"Bengbu Medical University  Bengbu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya\u2010Ya","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy The Second People's Hospital of Lanzhou  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Gansu Provincial Hospital  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2511-0156","authenticated-orcid":false,"given":"Liu\u2010Cheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Sir Run Run Shaw Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cui\u2010Li","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Lanzhou Maternal and Child Health Care Hospital  Lanzhou 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