In the US, doctor's are allowed to prescribe drugs "off-label". Pharmaceutical companies are not allowed to market "off-label." They must run a clinical trial (two phases) to prove the drug works for the new use and those results must be deemed acceptable by the FDA. If a pharmaceutical company markets a drug "off-label" they are no better than a 19th century quack selling elixirs out of a "medicine wagon" and moving on to the next town before they are tarred and feathered.
Anytime a doctor prescribes you a drug for an off-label application, they are basically betting that their personal rationalization of the drug's action and/or anecdotal evidence is strong enough to prove efficacy, but there is no empirical (factual) science behind that medical decision.
No better than a 19th century quack? Really?
If a pharmaceutical company is running two phase trials for what may be considered an 'off label' use for its medication, and the FDA approves it, are the doctors who learned of the drug's other benefits STILL no better than a 19th century quack?
In my earlier post, I noted a number of medications that were developed for one use, and side effects or other effects were discovered that made them useful for what were originally 'off label' uses.
Doctors who prescribe medications of off label indications may have strong evidence that supports the use - perhaps medical journals that report the off label uses of the drug, or information shared by other doctors who have learned of other uses and have had success in patients who received the off label medications.
It's not fair - and rather foolish to brand any physician who prescribes an off label medication as 'no better than a 19th century quack' or a foolish risk taker who is prescribing for an off label use that may have otherwise been well documented.
Look at aspirin -- it's for pain relief. Right? So why do people take it at the first signs of a stroke? Why are many of us taking baby doses on the assumption that it will be of value in heart patients? Aren't these 'off label' uses? Is taking two aspirin at the first sign of a stroke - a well documented first step that may help to reduce the damage caused by a stroke - and probably not an indication for prescribing it - an off label use? Should those who take it be considered risk takers?
I don't have a problem with off label prescriptions if the medication's 'off label' effects are well documented. Why do you?