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High-dose antipsychotic treatment in clinical practice

A review, audit and survey of consultant psychiatrist opinions

Published online by Cambridge University Press:  02 January 2018

Ann M. Mortimer
Affiliation:
Department of Psychiatry, University of Hull, Coniston House, Beverly Road, Willerby, Hull HU10 6NS
Jason A Wheeler
Affiliation:
Department of Psychiatry, University of Hull, Coniston House, Beverly Road, Willerby, Hull HU10 6NS
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Abstract

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Aims and method

A trust-wide audit of antipsychotic prescription was conducted in order to investigate the prevalence of high-dose treatment in a population with schizophrenia and assess compliance with Royal College of Psychiatrists' guidelines on the use of high doses. Details of antipsychotic medication were recorded and in cases of high-dose treatment compliance with the College's guidelines was assessed.

Results

Sixteen out of 361 patients (4%) were receiving high-dose medication. At re-audit this figure fell to four patients (1%). High-dose treatment comprised of a combined depot and oral medication in most cases. There was poor compliance with the College's guidelines.

Clinical implications

The study stresses the importance of monitoring patients on high-dose antipsychotics, particularly when taken in combination.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
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.
Copyright
Copyright © 1999 Royal College of Psychiatrists

References

British National Formulary (1997) British National Formulary. London: British Medical Association and the Royal Pharmaceutical Society of Great Britain.Google Scholar
Brotman, A. W. & McCormick, S. (1990) A role for high-dose antipsychotics. Journal of Clinical Psychiatry, 51, 164 166.Google Scholar
Dewan, M. J. & Koss, M. (1995) The clinical impact of reported variance in potency of antipsychotic agents. Acta Psychiatrica Scandinavica, 91, 229 232.CrossRefGoogle ScholarPubMed
Hirsch, S. & Barnes, T. (1994) Clinical use of high-dose neuroleptics. British Journal of Psychiatry, 164, 94 96.CrossRefGoogle ScholarPubMed
Krasucki, C. & McFarlane, F. (1996) Electrocardiograms, high-dose antipsychotic treatment and College guidelines. Psychiatric Bulletin, 20, 326 330.CrossRefGoogle Scholar
Mehtonen, O.-P., Aranko, K., Malkonen, L., et al (1991) A survey of sudden death associated with the use of antipsychotic or antidepressant drugs: 49 cases in Finland. Acta Psychiatrica Scandinavica, 84, 58 64.Google Scholar
Mortimer, A. M. (1994) Newer and older antipsychotics: a comparative review of appropriate use. CNS Drugs, 2, 381 396.CrossRefGoogle Scholar
Sillifant, K., Muir, J., Crabb, M., et al (1997) Monitoring of patients on high-dose antipsychotic medication. Psychiatric Bulletin, 21, 612 614.Google Scholar
Thompson, C. (1994) The use of high-dose antipsychotic medication. British Journal of Psychiatry, 164, 448 458.Google Scholar
Warner, J. P., Slade, R. & Barnes, T. R. E. (1995) Change in neuroleptic prescribing practice. Psychiatric Bulletin, 19, 237 239.Google Scholar
Yorston, G. & Pinney, A. (1997) Use of high-dose antipsychotic medication. Psychiatric Bulletin, 21, 566 569.Google Scholar
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