High dose antipsychotic therapy

Transcription

1 High dose antipsychotic therapy Promoting hope and wellbeing together

2 This leaflet gives you some information about High Dose Antipsychotic Therapy (HDAT). Your doctor, nurse or pharmacist has given you this leaflet because you may have had a discussion about your medication with your team. The medication that you have been prescribed may be prescribed resulting in high dose antipsychotic use. This leaflet is intended to explain in more detail what high dose antipsychotic therapy is, why it is used, and to help answer any questions that you may have. If you need to discuss anything further or need more information then please speak to your doctor, pharmacist or nurse. When are high dose antipsychotic medications used? Generally, antipsychotics are used within a maximum dose range; however, there are some circumstances where you may end up with a total daily dose above the recommended maximum. 2 West London Mental Health NHS Trust

3 High dose medication may be used when: A medication is being changed from one antipsychotic to another Medication has had some effect on symptoms, but symptoms have not completely gone away. When medication is used when required to manage symptoms that cause anxiety and agitation. Your doctor will discuss with you the reason why you have been started on high dose antipsychotic medication. What is high dose antipsychotic medication? High dose antipsychotic medication may occur when you are prescribed: 1. One antipsychotic medication that is above the manufacturer s recommended maximum dose which will be specified on the leaflet that is supplied with your medication e.g. the recommended maximum dose of olanzapine is 20mg, if you are prescribed more than 20mgs a day this would be high dose. This is also classed as off-label which is when a medicine is prescribed in a way that is not covered by its UK marketing licence. This does not mean that they are unsafe for this use. High dose antipsychotic therapy 3

4 2. A combination of regular antipsychotic medication when the dose of each medication results in the total dose being above 100% of the maximum recommend dose. For example you are prescribed the maximum dose of one antipsychotic and another antipsychotic is then also prescribed. You and your doctor may have found that a careful combination of two drugs is what controls your symptoms best. 3. PRN when required prescribing means that you may occasionally be given extra doses of your medication, in addition to your regular daily dose. This may result in high dose when the when required medication is used. What are the benefits of using high dose antipsychotic medications? Some people find using a higher than recommended dose or a combination of antipsychotic medication can help to better manage symptoms and support recovery. It is important to talk to your doctor, nurse or pharmacist about your experience with medication and if it is helping you. If high dose antipsychotic medication does not help, other available options can be discussed with your doctor. 4 West London Mental Health NHS Trust

5 What are the risks of using high dose antipsychotic medications? Some people may experience more side effects when using high dose antipsychotic medication. Patients on high dose antipsychotic medication are offered increased monitoring to identify and manage any side effects. It is important to tell your doctor, nurse or pharmacist if you experience any side effects. What monitoring will I need whilst I am on high dose antipsychotic therapy? The Royal College of Psychiatrists, have recommended a number of monitoring requirements for people on high dose antipsychotic therapy (HDAT) and these are listed below: Symptom rating scales these are checklists where symptoms can be documented and compared over time. Side effect rating scales these are checklists where side effects can be documented and compared over time. Blood pressure, pulse and temperature Blood tests to check if any changes in your physical health have occurred. An electrocardiogram (ECG) to assess the heart. High dose antipsychotic therapy 5

6 How often will the monitoring be carried out? Monitoring will be offered before you start taking high dose medication. This will be offered every 3 months initially, if the medication is stable and monitoring does not identify any changes, on-going monitoring can be carried less frequently, however the need to continue high dose medication should be reviewed at least every 3 months. Where can I get more information about my medicines? The Choice and Medication website has leaflets about a wide range of individual medicines used in mental health: The Royal College of Psychiatrist statement on high dose can be found here: collegereports/cr/cr190.aspx For more information on off-label use, please refer to the Use of unlicensed medicines and off-label uses information leaflet. If you don t have access to the internet you can ask a member of staff to print out the information for you. 6 West London Mental Health NHS Trust

7 Your notes High dose antipsychotic therapy 7

8 If you need this information in another format, such as Braille, large print, Easy Read or another language, please ask a member of staff. If you have questions or concerns about any of our services, please contact the patient advice and liaison service (PALS) on or pals@wlmht.nhs.uk. You can give feedback about any of our services at or on Switchboard Website wlmht.nhs.uk 24/7 24 hour helpline (single point of access) communications@wlmht.nhs.uk