Skip to main content
×
×
Home

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

  • John Milton (a1), John Lawton (a2), Mark Smith (a2) and Ann Buckley (a3)
Abstract
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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Hidden high-dose antipsychotic prescribing: effects of p.r.n. doses
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Hidden high-dose antipsychotic prescribing: effects of p.r.n. doses
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Hidden high-dose antipsychotic prescribing: effects of p.r.n. doses
      Available formats
      ×
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.
Corresponding author
Correspondence
References
Hide All
Bazire, S. (1997) Psychotropic Drug Directory. Dinton: Quay Books Division, Mark Allen publishing.
Cornwall, P., Hassanyeh, F. & Horn, C. (1996) High-dose antipsychotic medication. Improving clinical practice in a psychiatric special (intensive) care unit. Psychiatric Bulletin, 20, 676680.
Krasucki, C. & McFarlane, F. (1996) Electrocardiograms, high-dose antipsychotic treatment and College guidelines. Psychiatric Bulletin, 20, 326330.
Newton, K., Murthy, R. & Qureshi, J. (1997) Antipsychotic prescribing in light of the consensus statement of the College. Psychiatric Bulletin, 21, 408410.
Pinner, G. & Edgar, S. (1996) Audit of high-dose and combination antipsychotic medication prescribing. Pharmaceutical J, 256, 762763.
Singh, S., Croudace, T., Beck, A., et al (1998) Perceived ethnicity and risk of compulsory admission. Social Psychiatry and Psychiatric Epidemiology, 33, 3944.
Thompson, C. (1994) The use of high-dose antipsychotic medication (Consensus Statement). British Journal of Psychiatry, 164, 448458.
Torkington, B., Hogg, S., Powell, G., et al (1994) Antipsychotic medication use in relation to BNF guidelines. Psychiatric Bulletin, 18, 375376.
Warner, J., Slade, R. & Barnes, T. (1995) Change in neuroleptic prescribing practice. Psychiatric Bulletin, 19, 237239.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 12 *
Loading metrics...

Abstract views

Total abstract views: 24 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 18th July 2018. This data will be updated every 24 hours.

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

  • John Milton (a1), John Lawton (a2), Mark Smith (a2) and Ann Buckley (a3)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *