The Maudsley Prescribing Guidelines in 11th Edition David Taylor Director of Pharmacy and Pathology South London and Maudsley NHS Foundation Trust; Professor King's College London, London, UK Paton Chief Oxleas NHS Foundation Trust Honorary Research Fellow, Imperial College, London, UK Shitij Kapur Dean and Professor, Institute of Psychiatry King's College London, London, UK A John Sons, Ltd., Publication
Contents Preface ix Acknowledgements x Notes on using The Maudsley Prescribing Guidelines xi Notes on inclusion drugs xi List ofabbreviations xii Chaptcr 1 Plasma of psychotropic drugs and 1 Interpreting sample results 2 Chaptcr 2 Antipsychotic drugs Antipsychotic drugs: equivalent doses 13 Antipsychotic drugs: minimum effective doses 14 Antipsychotic drugs: licensed doses New antipsychotic drugs Antipsychotic drugs: general principles of prescribing National Institute for Health and Clinical Excellence guidelines for the 22 Treatment for schizophrenia 24 Antipsychotic drugs: of metabolic effects 26 Switching antipsychotic drugs because of poor tolerability Antipsychotic response: to increase the dose, to switch, to add or just wait - what is the right 33 Speed and onset of antipsychotic drug action 36 First-generation antipsychotic drugs: place in therapy 39 Antipsychotic drugs: injections 40 Risperidone long-acting injection 44 Paliperidone long-acting injection 47 Management of patients on depots: dose reduction 50
vi Contents Combined antipsychotic drugs High-dose antipsychotic drugs: prescribing and Negative in schizophrenia Antipsychotic Prophylaxis Refractory schizophrenia and Clozapine Clozapine Refractory schizophrenia: alternatives to Clozapine Clozapine: management of common adverse effects Clozapine: uncommon or unusual adverse effects Clozapine: serious haematological and cardiovascular adverse effects Clozapine, neutropenia and lithium Clozapine and chemotherapy Clozapine-related hypersalivation Guidelines for the initiation of Clozapine for patients based in the Community Omega-3 fatty acids (fish in schizophrenia Extrapyramidal side-effects of antipsychotic drug treatment Treatment of akathisia Treatment of tardive dyskinesia Neuroleptic malignant Syndrome Catatonia Cardiovascular effects of antipsychotic drug treatment Antipsychotic drugs and hypertension Hyperprolactinaemia Antipsychotic-induced weight gain Treatment of drug-induced weight gain Antipsychotic drugs, diabetes and glucose tolerance Antipsychotic drugs and dyslipidaemia Antipsychotic drugs and sexual dysfunction Antipsychotic-associated hyponatraemia Antipsychotics and pneumonia Relative adverse effects of antipsychotic drugs: a rough guide 51 54 57 60 64 66 69 75 78 80 84 88 89 92 96 98 103 105 110 Bipolar disorder Valproate 153 Lithium 159 Carbamazepine Physical monitoring of people with bipolar disorder Treatment of acute or hypomania Antipsychotic drugs in bipolar disorder Bipolar depression 5 Rapid cycling bipolar disorder Prophylaxis in bipolar disorder 193
Contents vii Depression and anxiety 197 Depression 197 Antidepressants 201 Treatment of resistant depression 222 Treatment of psychotic depression 233 Electroconvulsive therapy and psychotropic drugs 235 Psychostimulants in depression 239 Treatment of depression in the elderly 243 Treatment of depression in stroke 247 Adverse effects of antidepressants 249 Selective Serotonin reuptake inhibitors and bleeding 252 Depression and diabetes 255 Cardiac effects of antidepressants 257 Antidepressants and sexual dysfunction 264 Antidepressants and hyperprolactinaemia 268 Antidepressants: swapping and stopping 270 St wort in the treatment of depression 278 Drug interactions with antidepressants Alternative routes of administration for antidepressants 286 Anxiety spectrum disorders 292 Benzodiazepines in the treatment of Psychiatric disorders 301 Benzodiazepines and disinhibition 304 Benzodiazepines: dependence and detoxification 306 Insomnia 310 Chapter 5 Children and adolescents Principles of prescribing practice in childhood and adolescence Depression in children and adolescents Bipolar illness in children and adolescents Psychosis in children and adolescents 326 Anxiety in children and adolescents 327 Obsessive compulsive disorder in children and adolescents 328 Attention deficit hyperactivity disorder 332 spectrum disorders 337 Tics and Tourette's Syndrome 345 Melatonin in the treatment of insomnia in children and adolescents 349 Rapid tranquillisation in children and adolescents Doses of commonly used psychotropic drugs in children and adolescents 354 Chapter 6 Substance 355 Alcohol dependence 356 Opioid misuse and dependence 372 Nicotine and smoking cessation 398
viii Contents Stimulant drugs of dependence 406 Benzodiazepine misuse 407 and -hydroxybutyrate dependence 408 Drugs of misuse: a Interactions between 'street drugs' and prescribed psychotropic drugs 414 Chapter 7 Use of psychotropic drugs in special patient groups 419 Epilepsy 419 Pregnancy 430 Breast feeding 446 Renal 462 Hepatic impairment 478 Prescribing in the elderly 487 Dementia 490 Behavioural and psychological Symptoms of dementia 509 Parkinsons disease 518 Multiple sclerosis 522 Eating disorders 527 Acutely disturbed or violent behaviour Psychotropic medications for adults with learning disabilities 539 Borderline personality disorder 545 Delirium 547 Huntington's disease 554 Psychotropic drugs and surgery 558 Prescribing psychotropic drugs for patients with HIV infection 564 Psychotropic drugs and cytochrome (CYP) function 573 Summary of Psychiatric side-effects of non-psychotropic drugs 578 Chapter 8 Miscellaneous conditions and substances 587 Psychotropic drugs in overdose 587 and haematological effects of psychotropic drugs 593 Prescribing drugs outside their licensed indications 604 Observations on the placebo effect in mental illness 606 Drug interactions with alcohol 608 Nicotine Smoking and psychotropic drugs 616 Caffeine 618 Complementary therapies 624 Enhancing medication adherence 628 Driving and psychotropic medicines 634 Covert administration of medicines within food and drink 643 Index 647