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Antipsychotic drugs for non-psychotic patients

Results of a questionnaire survey of prescribing practices among Wessex psychiatrists

Published online by Cambridge University Press:  02 January 2018

Redwan El-Khayat*
Affiliation:
Old Manor Hospital, Wilton Road, Salisbury, Wiltshire SP2 7EP
David S. Baldwin
Affiliation:
Mental Health Group, Faculty of Medicine, Health and Biological Sciences, University of Southampton, Southampton, UK
*
Correspondence
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Abstract

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Aims and method

The aim of this study was to examine the pattern and basis of use of psychotropic drug prescriptions by psychiatrists to relieve anxiety symptoms arising from non-psychotic disorders. A questionnaire survey was conducted among senior psychiatrists in the Wessex region.

Results

The response rate was 74%. A range of psychotropic drugs was used to treat non-psychotic anxiety symptoms, most commonly selective serotonin re-uptake inhibitors, tricyclic antidepressants and antipsychotic drugs. Antipsychotic drugs are reserved for second- and third-line treatments, mainly in low doses but sometimes in high doses and for long periods. The use of antipsychotic drugs as anxiolytics was seen by the majority of responders as reasonable practice, and they are considered suitable alternatives to benzodiazepines. This practice was based mainly on personal experience.

Clinical implications

Anxiety symptoms arising from non-psychotic disorders are common in the out-patient population. Although antipsychotics are used by psychiatrists to relieve these symptoms, the ‘evidence base’ for such practice is flimsy and mainly based on clinical experience. The benefit/risk ratio should be considered carefully before prescribing antipsychotics for non-psychotic anxiety. Further research is needed in this area, contributing towards general guidelines.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1999 The Royal College of Psychiatrists

References

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