with psychosis on too much medication
by Mike Jones
than a third of people diagnosed with psychosis are being given
excessive levels of antipsychotic medication.
This could be because medication is not being reduced following
a mental health crisis during which antipsychotic drugs are often
increased, a Healthcare Commission report stated.
The commission's report quoted an
audit by the Prescribing Observatory for Mental Health which found
36% of people were prescribed a high dose (more than 100% of the
maximum recommended daily dose) of antipsychotic medicines.
The commission, which monitors
healthcare services, made a number of recommendation to NHS trusts
on how to improve medication prescribing for people with mental
Commission's Talking About Medicines report (pdf)
18: More than 40 psychiatric inpatients per year die of "unexplained”
causes - antipsychotic drugs, physical restraint and heart disease
could be causing such deaths, states new report
Rupa Shah, student mental health nurse, Manchester University
August 3, 2009
I met a psychiatrist who started a patient on quetiapine on very
low doses and reviewed them as an out-patient every couple of weeks.
main symptoms she asked the patient was to do with sleep and anxiety
levels. The quetiapine was then prescribed in 25mg tablets as prn
and the psychistrist put the control in the hands of the patient
to decide when to have an extra dose or miss a dose.
patient thus sustained fairly good functioning and was able to deal
with the causes of her anxiety slowly, with the prn as a safety
net. I believe this is in keeping with NICE guidelines recommending
the lowest possible dose.
psychiatrist did work with the patient and enabled her to have confidence
in recovery. She was able to return to work and has not relapsed
for a few years. Just a note in praise of this psychiatrist!
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