OBJECTIVES: Atypical antipsychotics (AAP) are commonly used to treat off-label conditions such as anxiety, depression, and post-traumatic stress disorder. Despite a black box warning in 2005, AAP still remain the second most common therapeutic class used for dementia. The objective of the study is to determine resource utilization (RU) and costs in patients using AAP to treat off-label conditions.  METHODS: A retrospective cross-sectional study was conducted using 2009 Medical Expenditure Survey (MEPS) data. Study sample included individuals aged ≥ 18 years with at least 2 claims for AAP identified from the Prescribed Medicines file. Indications were identified using ICD-9-CM and CCCODEX codes from the Medical Conditions file. Schizophrenia and bipolar disorder were categorized as FDA approved indications; all other indications were categorized as off-label use. RU and costs were obtained from the Full-Year Consolidated Files.  RESULTS: N=352 patients had at least 2 claims for AAP. 55.7% were off-label users with 1,442 AAP claims. The most common off-label conditions were depressive disorder (29.89% of claims), neurotic disorders (15.40%) and general symptoms (13.80%). 5.20% of the claims were for dementia. The typical off-label AAP user was female (60.20%), White (67.86%) with mean age 51.11+16.81 years (R: 18-85). Mean RU for off-label users was 14.61+16.79 (0-138) office-based provider visits, 1.41+3.94 (0-32) hospital-outpatient visits, 0.61+1.38 (0-12) ED visits, and 0.36+0.83 (0-4) inpatient discharges. The average total cost was $13,751.64 per person. For FDA approved users, mean RU was 17.77+26.73 (0-216) office-based provider visits, 2.51+11.83 (0-123) hospital-outpatient visits, 0.71+1.22 (0-7) ED visits, and 0.39+0.84 (0-5) inpatient discharges. The average total cost was $14,573.93 per person.  CONCLUSIONS: Off-label prescribing of AAP is still a prevalent practice and needs to be monitored. Future research will compare RU and costs among patients prescribed and not prescribed AAP for off-label indications.