'As required' medication regimens for seriously mentally ill people in hospital

Evaluation of the Use of the Positive and Negative Syndrome Scale-Excited Component as a Criterion for Administration of P.R.N. Medication

“…medications. 7,10,11 This study suggests that the practice of administering p.r.n. medication to patients on acute psychiatric units can be supported through instrument-based assessment.…”

“…medication 13 and the circumstances of reallife psychiatric practice, in which administration of medication tends to be based on the experience of individual practitioners. 7,10,11 Several factors may limit interpretation of the data presented here. These include the inherent limitations of a retrospective study and a pre-and post-comparison design.…”

“…(as needed) doses of medication for these symptoms is a frequent practice on psychiatric inpatient units. [7][8][9] Studies have shown that clinicians tend to base decisions about how to dose p.r.n. psychotropic medications on clinical experience rather than high-quality evidence, and studies are lacking concerning valid assessments that can be used to support the decision to administer p.r.n.…”

Schizophrenia trials: past, present and future

“…Others do not include data from any trials at all. For example, a recent review on use of "as required" medication for people coming into hospital, failed to identify any relevant randomised studies (Whicher et al, 2002). This very common clinical practice is unsupported by good evidence.…”

Limited Evidence for the Effectiveness of P.R.N. Medications Among Psychiatric Inpatients

“…medications in psychiatric inpatients, 3 the authors noted that no randomized trials had been done and concluded "current practice could be far more helpful or harmful than is currently perceived." An update to this Cochrane report that reviewed studies through March 2006 produced similar conclusions.…”