The Maudsley 2005-2006 Prescribing Guidelines

by Taylor, David; Paton, Carol; Kerwin, Robert

• ISBN13: 9781841845005
• ISBN10: 1841845000
• Edition: 8th
• Format: Paperback
• Copyright: 2005-06-07
• Publisher: Informa HealthC

Summary

Now in its eighth edition, The Maudsley Prescribing Guidelinesis the most widely used guide to psychiatric prescribing in the UK. Fully updated throughout, this new edition presents sections on topics of current interest such as antipsychotics and hyperlipidaemia, antipsychotic-induced hyponatraemia, borderline personality disorder, depression in multiple sclerosis, and melatonin for the treatment of insomnia in children and adolescents. Providing practically useful advice for common clinical situations, this is an essential text for prescribers, nursing staff, pharmacists, GPs, and those in related professions.

Author Biography

Carol Paton is Chief Pharmacist, Oxleas NHS Trust, South East London.

Table of Contents

Authors and editors	xi
Preface	xiii
Acknowledgements	xiv
Notes on using The Maudsley Prescribing Guidelines	xv
Notes on inclusion of drugs	xv
Notes on commonly used abbreviations	xv
Notes on nomenclature	xv
1 Plasma level monitoring of psychotropics and anticonvulsants	1	(6)
Introduction	1	(1)
Interpreting sample results	2	(2)
Clozapine plasma levels	4	(2)
Olanzapine plasma levels	6	(1)
2 Schizophrenia	7	(100)
General introduction to antipsychotics	7	(4)
Antipsychotics - equivalent doses	11	(1)
Antipsychotics - minimum effective doses	12	(1)
Antipsychotics - licensed maximum doses	13	(1)
New antipsychotics - costs	14	(1)
Choice of antipsychotic	15	(5)
Newer antipsychotics	20	(2)
Antipsychotics - general principles of prescribing	22	(1)
Atypical antipsychotics - summary of NICE guidance	23	(1)
1st episode schizophrenia	24	(1)
Relapse or acute exacerbation of schizophrenia	25	(2)
Switching antipsychotics because of poor tolerability - recommendations	27	(2)
Typical antipsychotics - clinical utility	29	(1)
New antipsychotics - recommended monitoring	30	(5)
Depot antipsychotics	35	(2)
Risperidone long-acting injection	37	(1)
Switching to risperidone long-acting injection (RLAI)	38	(1)
Management of patients on long-term depots	39	(1)
Antipsychotic polypharmacy	40	(1)
High-dose antipsychotics: prescribing and monitoring	41	(2)
Negative symptoms	43	(1)
Antipsychotic prophylaxis	44	(3)
Refractory schizophrenia	47	(4)
Refractory schizophrenia - alternatives to clozapine	51	(3)
Clozapine - management of common adverse effects	54	(2)
Clozapine - uncommon or unusual adverse effects	56	(2)
Clozapine - serious adverse effects	58	(2)
Clozapine, neutropenia and lithium	60	(3)
Clozapine-related hypersalivation	63	(2)
Guidelines for the initiation of clozapine for patients based in the community	65	(2)
Clozapine in the community - acute monitoring requirements	67	(2)
Fish oils in schizophrenia	69	(2)
Extra-pyramidal side-effects (EPSEs)	71	(3)
Hyperprolactinaemia	74	(2)
Algorithm for the treatment of antipsychotic-induced akathisia	76	(2)
Treatment of tardive dyskinesia (TD)	78	(3)
Neuroleptic malignant syndrome (NMS)	81	(2)
Antipsychotic-induced weight gain	83	(1)
Treatment of drug-induced weight gain	84	(3)
Psychotropic-related QT prolongation	87	(5)
Antipsychotics, diabetes and impaired glucose tolerance	92	(4)
Antipsychotics and hyperlipidaemia	96	(3)
Antipsychotics and sexual dysfunction	99	(5)
Antipsychotic-induced hyponatraemia	104	(2)
Antipsychotics: relative adverse effects - a rough guide	106	(1)
3 Bipolar disorder	107	(28)
Valproate	108	(2)
Lithium	110	(7)
Carbamazepine	117	(3)
Mood stabilising agents	120	(2)
Treatment of acute mania or hypomania	122	(4)
Antipsychotics in bipolar disorder	126	(2)
Bipolar depression	128	(4)
Rapid-cycling bipolar affective disorder	132	(2)
Prophylaxis in bipolar disorder	134	(1)
4 Depression and anxiety	135	(70)
Antidepressant drugs - tricyclics	136	(2)
Antidepressant drugs - SSRIs	138	(2)
Antidepressant drugs - MAOIs	140	(2)
Antidepressant drugs - others	142	(2)
Treatment of affective illness	144	(1)
Drug treatment of depression	145	(3)
Antidepressant prophylaxis	148	(2)
Treatment of refractory depression - first choice	150	(2)
Treatment of refractory depression - second choice	152	(1)
Treatment of refractory depression - other reported treatments	153	(3)
Psychotic depression	156	(1)
Electroconvulsive therapy (ECT) and psychotropics	157	(2)
Antidepressant-induced hyponatraemia	159	(2)
Post-stroke depression	161	(2)
Treatment of depression in the elderly	163	(3)
Cardiac effects of antidepressants	166	(3)
Antidepressants and sexual dysfunction	169	(2)
Antidepressants - swapping and stopping	171	(5)
Antidepressant discontinuation symptoms	176	(3)
St John's Wort	179	(3)
Drug interactions with antidepressants	182	(4)
Anxiety spectrum disorders	186	(7)
Benzodiazepines	193	(3)
Benzodiazepines and disinhibition	196	(2)
Benzodiazepines: dependence and detoxification	198	(3)
Insomnia	201	(4)
5 Children and adolescents	205	(24)
Principles of prescribing practice in childhood and adolescence	206	(1)
Depression in children and adolescents	207	(2)
Bipolar illness in children and adolescents	209	(3)
Anxiety in children and adolescents	212	(1)
Obsessive compulsive disorder (OCD) in children and adolescents	213	(1)
Attention deficit hyperactivity disorder (ADHD)	214	(4)
Psychosis in children and adolescents	218	(1)
Autism	219	(2)
Tourette's syndrome	221	(3)
Melatonin in the treatment of insomnia in children and adolescents	224	(2)
Rapid tranquillisation (RT) in children and adolescents	226	(1)
Persistent aggression in children and adolescents	227	(2)
6 Substance misuse	229	(30)
Alcohol	229	(10)
Opioid dependence	239	(9)
Opioid detoxification and reduction regimes	248	(4)
Drugs of misuse - a summary	252	(2)
Interactions between 'street drugs' and prescribed psychotropic drugs	254	(5)
7 Use of psychotropics in special patient groups	259	(78)
Depression and psychosis in epilepsy	259	(4)
Drug interactions between antiepileptic drugs and other psychotropic drugs	263	(3)
Withdrawing anticonvulsant drugs	266	(2)
Drug choice in pregnancy	268	(8)
Breast-feeding guidelines	276	(7)
Renal impairment	283	(10)
Hepatic impairment	293	(6)
Prescribing in the elderly	299	(2)
Alzheimer's disease	301	(7)
Parkinson's disease	308	(3)
Multiple sclerosis and depression	311	(2)
Acutely disturbed or violent behaviour	313	(6)
Chronic behavioural disturbance in learning disability	319	(1)
Self-injurious behaviour in learning disability	320	(3)
Psychotropics and surgery	323	(3)
General principles of prescribing in HIV	326	(7)
Drug treatment of borderline personality disorder	333	(4)
8 Miscellaneous conditions and substances	337	(28)
Psychotropics in overdose	337	(4)
Observations on the placebo effect in mental illness	341	(1)
Drug interactions with alcohol	342	(5)
Nicotine	347	(3)
Caffeine	350	(3)
Complementary therapies	353	(4)
Driving and psychotropic drugs	357	(5)
Communication with patients/service users	362	(1)
Use of antibiotics in psychiatry	363	(2)
Index	365