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People diagnosed with psychosis on too much medication

January 31, 2007
by Mike Jones

More 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 health problems.

Read for yourself:
Healthcare Commission's Talking About Medicines report (pdf)

See also:
Dec 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


Some good practice

From: Rupa Shah, student mental health nurse, Manchester University
Date: 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.

The 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.

The 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.

The 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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