Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-25T16:28:46.940Z Has data issue: false hasContentIssue false
  • English
  • Français

Hidden high-dose antipsychotic prescribing: effects of p.r.n. doses

Published online by Cambridge University Press:  02 January 2018

John Milton ,
John Lawton ,
Mark Smith  and
Ann Buckley
John Milton*
Affiliation:
Nottingham Healthcare NHS Trust, Duncan Macmillan House, Porchester Road, Nottingham NG3 6AA
John Lawton
Affiliation:
Clinical Audit Department, Nottingham Healthcare NHS Trust, Nottingham
Mark Smith
Affiliation:
Clinical Audit Department, Nottingham Healthcare NHS Trust, Nottingham
Ann Buckley
Affiliation:
South Birmingham Mental Health NHS Trust, Mindleson Way, Birmingham
*
∗Correspondence
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Aims and method

The Royal College of Psychiatrists' Consensus Statement on “The use of high-dose antipsychotic medication’ suggests only fully qualified psychiatrists (MRCPsych) should recommend the prescribing of high-dose antipsychotic treatment. We observed changes in anti-psychotic prescribing in two surveys of psychiatric in-patients conducted eight and 32 months after publication of the Consensus Statement.

Results

Overall mean chlorpromazine equivalent doses of antipsychotic drugs reduced between the surveys. When p.r.n. (as required) prescribing (usually done by junior doctors) is included, mean potential doses and numbers of patients who might receive ‘high-doses' increases substantially, although the reduction between surveys in total mean dose and proportion of patients on high-dose antipsychotic medication is preserved, and the actual use of p.r.n. medication was low (4–5% of p.r.n. prescriptions).

Clinical implications

We recommend the development of local guidelines for junior staff concerning antipsychotic drug prescribing, regular monitoring of p.r.n. medication by consultants, and pharmacists' involvement in reviews of patients prescribed high-dose antipsychotic medication.

Type
Original Papers
Information
Psychiatric Bulletin , Volume 22 , Issue 11 , November 1998 , pp. 675 - 677
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 © 1998 The Royal College of Psychiatrists

References

Bazire, S. (1997) Psychotropic Drug Directory. Dinton: Quay Books Division, Mark Allen publishing.Google Scholar
Cornwall, P., Hassanyeh, F. & Horn, C. (1996) High-dose antipsychotic medication. Improving clinical practice in a psychiatric special (intensive) care unit. Psychiatric Bulletin, 20, 676–680.Google Scholar
Krasucki, C. & McFarlane, F. (1996) Electrocardiograms, high-dose antipsychotic treatment and College guidelines. Psychiatric Bulletin, 20, 326–330.Google Scholar
Newton, K., Murthy, R. & Qureshi, J. (1997) Antipsychotic prescribing in light of the consensus statement of the College. Psychiatric Bulletin, 21, 408–410.Google Scholar
Pinner, G. & Edgar, S. (1996) Audit of high-dose and combination antipsychotic medication prescribing. Pharmaceutical J, 256, 762–763.Google Scholar
Singh, S., Croudace, T., Beck, A., et al (1998) Perceived ethnicity and risk of compulsory admission. Social Psychiatry and Psychiatric Epidemiology, 33, 39–44.Google Scholar
Thompson, C. (1994) The use of high-dose antipsychotic medication (Consensus Statement). British Journal of Psychiatry, 164, 448–458.Google Scholar
Torkington, B., Hogg, S., Powell, G., et al (1994) Antipsychotic medication use in relation to BNF guidelines. Psychiatric Bulletin, 18, 375–376.Google Scholar
Warner, J., Slade, R. & Barnes, T. (1995) Change in neuroleptic prescribing practice. Psychiatric Bulletin, 19, 237–239.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.