“routine” prescribing of high-dose antipsychotics, psychiatrists
by Angela Hussain
should end the “routine” prescribing of high-dose antipsychotics
to adult patients, a report has recommended.
Royal College of Psychiatrists (RCP) report reveals that up to a
quarter of adult psychiatric in-patients are on high doses of antipsychotics.
The report recognises there is a "possible link" between
antipsychotic drugs and sudden death. However the report adds there
is "no consensus" on there being a causal link.
The RCP working group which compiled the report defines a “high
dose” as either a daily dose of an antipsychotic which exceeds
the upper limit stated in the British National Formulary, or a total
daily dose of two or more antipsychotics which exceeds the formulary’s
High-dose antipsychotics should only be prescribed after a risk–benefit
assessment by a fully trained psychiatrist, said the report.
should be undertaken in consultation with the wider clinical team
and the patient and a patient advocate, if available”, read
the "consensus statement" report.
also states that evidence reveals that high-dose prescribing for
"treatment-resistant" schizophrenia is "unsuccessful
or inappropriate". Therefore, high doses should "rarely
be used" in such cases.
College of Psychiatrists' consensus statement on high-dose antipsychotic
Mental health comment
Feb 7, 2005: Compassion
not compulsion - psychiatric treatment by force amounts to state-sponsored
violence, says clinical psychologist Rufus May.
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