The Maudsley Prescribing Guidelines, Tenth Edition
| Date: 28 April 2011, 02:51
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The Maudsley Prescribing Guidelines, Tenth Edition (Taylor, The Maudsley Prescribing Guidelines)
By David Taylor, Carol Paton
* Publisher: Informa Healthcare
* Number Of Pages: 542
* Publication Date: 2009-10-30
* ISBN-10 / ASIN: 1841846996
* ISBN-13 / EAN: 9781841846996
Product Description:
This text provides clinical advice and research for the effective prescription of psychotropic medications.
What’s inside:
NEW SECTIONS — with clinical guidance on using psychotropics in atrial fibrillation and alternative routes for antidepressant administration
EXPERT CONTRIBUTIONS — over 40 leaders in psychiatric medicine provide advice derived from their clinical experiences and current literature
COMPREHENSIVE CONTENT — on current and promising therapies for schizophrenia, bipolar disorder, anxiety, and depression, as well as substance abuse/misuse, in all patient populations
NICE GUIDANCE AND COCHRANE REVIEWS — guidelines from the UK National Institute for Health and Clinical Excellence and the Cochrane Collaboration provide standards for prescribing psychiatric medications
“FUTURE-PROOF” INFORMATION — accurate predictions of psychiatric prescription procedures and treatments for improving patient outcomes
Preface:
The 10th edition of the Maudsley Prescribing Guidelines fully updates the 9th edition and includes
new sections offering guidance on, for example, the use of psychotropics in atrial fibrillation,
alternative routes for antidepressant administration, the treatment of velo-cardio-facial syndrome
and the covert administration of medicines. Where possible guidance has been aligned with the
most recently issued guidelines from UK NICE and the latest Cochrane reviews. There has also been
an attempt to make the text ‘future-proof ’ (at least for a year or two) by anticipating new drug
introductions and changes in Product Licences.
Following the tragic loss of Rob Kerwin in 2007, we now welcome Shitij Kapur as a co-author of the
Prescribing Guidelines. Shitij is one of the world’s foremost researchers in the field of schizophrenia
and is widely recognised for his innovative and cogently argued theories on the causes and treatment
of psychosis. We are honoured to have Shitij as part of our team and it serves as an honour to
Rob Kerwin that only an illustrious clinician as Shitij could be considered a suitable replacement.
As before, we are indebted to a great many people who have contributed their time and expertise to
the Prescribing Guidelines in expectation of no more than being mentioned on the following page.
The Guidelines would be nothing without their invaluable contributions. Thanks are also due to
those who have written to me making suggestions about the Guidelines and to both formal and
internet reviewers who have provided precious feedback on previous editions. Particular thanks are
due to Maria O'Hagan who has managed the production of this and several previous editions of the
Maudsley Prescribing Guidelines.
Contents
Authors and editors v
Preface vi
Acknowledgements vii
Notes on using The Maudsley Prescribing Guidelines viii
Notes on inclusion of drugs viii
Notes on commonly used abbreviations viii
Plasma level monitoring of psychotropics and anticonvulsants
Introduction 1
Interpreting sample results 2
Amisulpride 4
Aripiprazole 4
Clozapine 4
Olanzapine 5
Quetiapine 5
Risperidone 6
Schizophrenia
Antipsychotics – general introduction 9
Antipsychotics – equivalent doses 11
Antipsychotics – minimum effective doses 12
Antipsychotics – licensed maximum doses 14
New antipsychotics 15
New antipsychotics – costs 17
Antipsychotics – general principles of prescribing 18
NICE Guidelines – Schizophrenia 19
First-episode schizophrenia 21
Relapse or acute exacerbation of schizophrenia 22
Switching antipsychotics because of poor 24
tolerability – recommendations
Antipsychotic response to increase the dose, to switch, 26
to add or just wait – what is the right move?
Speed and onset of antipsychotic action 29
First-generation antipsychotics – place in therapy 31
Antipsychotics – monitoring 32
Depot antipsychotics 35
Risperidone long-acting injection 38
Management of patients on long-term depots – 41
dose reduction
Combined antipsychotics 42
High-dose antipsychotics: prescribing and monitoring 44
Negative symptoms 47
Antipsychotic prophylaxis 49
Refractory schizophrenia 53
Optimising clozapine treatment 55
Alternatives to clozapine 58
Clozapine – management of common adverse effects 62
Clozapine – uncommon or unusual adverse effects 64
Clozapine – serious haematological and 66
cardiovascular adverse effects
Clozapine, neutropenia and lithium 68
Clozapine-related hypersalivation 71
Clozapine and chemotherapy 74
Guidelines for the initiation of clozapine for patients based 75
in the community
Omega-3 fatty acid (fi sh oils) in schizophrenia 78
Extrapyramidal side-effects 80
Hyperprolactinaemia 83
Algorithm for the treatment of antipsychotic-induced akathisia 85
Treatment of tardive dyskinesia (TD) 87
Neuroleptic malignant syndrome (NMS) 90
Catatonia 92
Antipsychotics and hypertension 94
Antipsychotic-induced weight gain 96
Treatment of drug-induced weight gain 97
Psychotropic-related QT prolongation 101
Antipsychotics, diabetes and impaired glucose tolerance 107
Antipsychotics and dyslipidaemia 111
Antipsychotics and sexual dysfunction 114
Antipsychotic-induced hyponatraemia 119
Antipsychotics: relative adverse effects – a rough guide 122
Bipolar disorder
Valproate 123
Lithium 128
Carbamazepine 134
Treatment of acute mania or hypomania 140
Antipsychotics in bipolar disorder 145
Bipolar depression 147
Rapid-cycling bipolar affective disorder 151
Prophylaxis in bipolar disorder 153
Depression and anxiety
Antidepressants 155
Antidepressant drugs – tricyclics 158
Antidepressant drugs – SSRIs 160
Antidepressant drugs – MAOIs 164
Antidepressant drugs – others 166
Treatment of affective illness 170
Drug treatment of depression 171
Recognised minimum effective doses – antidepressants 173
Antidepressant prophylaxis 174
Treatment of refractory depression – fi rst choice 177
Treatment of refractory depression – second choice 181
Treatment of refractory depression – other 182
reported treatments
Psychotic depression 185
Electroconvulsive therapy (ECT) and psychotropics 187
Stimulants in depression 190
Antidepressant-induced hyponatraemia 193
Post-stroke depression 195
SSRIs and bleeding 197
Antidepressants and diabetes mellitus 199
Treatment of depression in the elderly 201
Cardiac effects of antidepressants 204
Antidepressant-induced arrhythmia 207
Antidepressants and sexual dysfunction 209
Antidepressants and hyperprolactinaemia 212
Antidepressants – swapping and stopping 214
Antidepressant discontinuation symptoms 220
St John’s Wort 223
Drug interactions with antidepressants 226
Antidepressants: relative adverse effects – a rough guide 229
Antidepressants – alternative routes of administration 230
Anxiety spectrum disorders 234
Benzodiazepines 240
Benzodiazepines and disinhibition 243
Benzodiazepines: dependence and detoxifi cation 245
Insomnia 248
Children and adolescents
Principles of prescribing practice in childhood 252
and adolescence
Depression in children and adolescents 253
Bipolar illness in children and adolescents 256
Anxiety in children and adolescents 259
Obsessive compulsive disorder (OCD) in children 260
and adolescents
Attention defi cit hyperactivity disorder (ADHD) 263
Prescribing in ADHD – a summary 266
Psychosis in children and adolescents 269
Autism spectrum disorders 270
Tics and Tourette syndrome 276
Melatonin in the treatment of insomnia in children 279
and adolescents
Rapid tranquillisation (RT) in children and adolescents 281
Doses of commonly used psychotropic drugs in 283
children and adolescents
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