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Antipsychotic drugs for non-psychotic patients: Results of a questionnaire survey of prescribing practices among Wessex psychiatrists

  • Redwan El-Khayat (a1) and David S. Baldwin (a2)
Abstract
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.

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Copyright
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.
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References
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El-Khayat, R. & Baldwin, D. (1998) Antipsychotic drugs for non-psychotic patients: assessment of the benefit/risk ratio in generalised anxiety disorder. Journal of Psychopharmacology, 12, 323 329.
Knottnerus, J. A. & Dinant, G. J. (1997) Medicine based evidence, a prerequisite for evidence based medicine. British Medical Journal, 315, 1109 1110.
Royal College of Psychiatrists (1997) Benzodiazepines: Risks, Benefits or Dependence: a Re-evaluation. London: Royal College of Psychiatrists.
Thompson, C. (1994) Consenus statement on the use of high-dose antipsychotic medication, Royal College of Psychiatrists. British Journal of Psychiatry, 164. 448 458.
Ustun, T. B. & Sartorius, N. (1995) Mental Illness in General Health Care . An International Study. Chichester: Wiley.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Antipsychotic drugs for non-psychotic patients: Results of a questionnaire survey of prescribing practices among Wessex psychiatrists

  • Redwan El-Khayat (a1) and David S. Baldwin (a2)
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