High-dose antipsychotic treatment in clinical practice

Abstract

Aims and methodA 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.ResultsSixteen 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 implicationsThe study stresses the importance of monitoring patients on high-dose antipsychotics, particularly when taken in combination.

Antipsychotics in clinical practice: guidelines for safe and effective use

“…The principal difference between the classical and atypical antipsychotic drugs relates to their side-effect profile and particularly the propensity of classical antipsychotics to cause tardive dyskinesia (Tyson et al, 1999). Side-effects are usually dose related but with careful monitoring can be easily detected (Chaplin et al, 1999).…”