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The Maudsley

Prescribing Guidelines

inPsychiatry Anyone wishing to license all or part of this book in electronic format for integration into a software product, please contact digitalrights@wiley.com Anyone wishing to license this title for translation, please contact rightsuk@wiley.com

The Maudsley

PrescribingGuidelines

inPsychiatry

13th Edition

David M. Taylor, BSc, MSc, PhD, FFRPS, FRPharmS

Director of Pharmacy and Pathology at the Maudsley Hospital and Professor of Psychopharmacology at King"s College, London, UK

Thomas R. E. Barnes, MBBS, MD, FRCPsych, DSc

Emeritus Professor of Clinical Psychiatry at Imperial College London and joint-head of the Prescribing Observatory for Mental Health at the Royal College of Psychiatrists" Centre for Quality Improvement, London, UK Allan H. Young, MB, ChB, MPhil, PhD, FRCPC, FRCPsych Chair of Mood Disorders and Director of the Centre for Affective Disorders in the Department of Psychological Medicine in the Institute of Psychiatry at

King"s College London, UK

This thirteenth edition first published 2018

© 2018 David M. Taylor

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any

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onhow to obtain permission to reuse material from this title is avai lable at http://www.wiley.com/go/permissions.

The right of David M. Taylor, Thomas R. E. Barnes and Allan H. Young to be identified as the author(s) of this work has

been asserted in accordance with law.

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Library of Congress CataloginginPublication Data

Names: Taylor, David M., 1963- author. | Barnes, Thomas R. E., author. | Young, Allan H., 1938- author.

Title: The Maudsley prescribing guidelines in psychiatry / David M. Taylor, Thomas R. E. Barnes, Allan H. Young.

Other titles: Prescribing guidelines in psychiatry

Description: 13th edition. | Hoboken, NJ : Wiley, 2019. | Includes bibliographical references and index. |

Identifiers: LCCN 2018013198 (print) | LCCN 2018013542 (ebook) | ISB

N 9781119442561 (pdf) |

ISBN 9781119442585 (epub) | ISBN 9781119442608 (pbk.) | ISBN 9781119

442561 (ePDF)

Subjects: | MESH: Mental Disorders-drug therapy | Psychotropic Drugs- therapeutic use | Psychotropic Drugs-administration & dosage | Psychopharmacology-me thods Classification: LCC RC483 (ebook) | LCC RC483 (print) | NLM WM 402 | DDC 616.89/18-dc23 LC record available at https://lccn.loc.gov/2018013198

Cover design by Wiley

Set in 10/12pt Sabon by SPi Global, Pondicherry, India 1 2018

Contents

Preface

x

Acknowledgements

xii

Notes on using

The Maudsley Prescribing Guidelines

in Psychiatry xiii

List of abbreviations

xv

Part 1

Drug treatment of major psychiatric conditions 1

Chapter 1

Schizophrenia andrelated psychoses 3

ANTIPSYCHOTIC DRUGS

3

General introduction

3

General principles ofprescribing

8

Minimum effective doses

9

Licensed maximum doses

12

Equivalent doses

14 Highdose antipsychotics: prescribing andmonitoring 16

Combined antipsychotics

20

Antipsychotic prophylaxis

25

Negative symptoms

31

Monitoring

36

Relative adverse effects-arough guide

39

Treatment algorithms forschizophrenia

40

Firstgeneration antipsychotics-place intherapy

44

NICE guidelines forthetreatment ofschizophrenia

46
Antipsychotic response-toincrease thedose, toswitch, toadd or just wait-what is theright move? 49

Acutely disturbed or violent behaviour

54

Antipsychotic depots/longacting injections (LAIs)

66

Depot/LAI antipsychotics-pharmacokinetics

71

Management ofpatients onlongterm depots/LAIs

73

Aripiprazole longacting injection

75

Olanzapine longacting injection

77

Paliperidone palmitate longacting injection

79

Risperidone longacting injection

82
viContents

Electroconvulsive therapy andpsychosis

86

Omega3 fatty acid (fish oils) inschizophrenia

88

ANTIPSYCHOTIC ADVERSE EFFECTS

90

Extrapyramidal symptoms

90

Akathisia

94

Weight gain

97

Treatment ofantipsychoticinduced weight gain

99

Neuroleptic malignant syndrome

104

Catatonia

107

ECG changes - QT prolongation

112
Effect of antipsychotic medications on plasma lipids 119

Diabetes andimpaired glucose tolerance

123

Blood pressure changes

130

Hyponatraemia

134

Hyperprolactinaemia

137

Sexual dysfunction

141

Pneumonia

148

Switching antipsychotics

150

Venous thromboembolism

153

REFRACTORY SCHIZOPHRENIA ANDCLOZAPINE

156

Clozapine initiation schedule

156

Optimising clozapine treatment

158

Alternatives toclozapine

162

Restarting clozapine after abreak intreatment

169

Initiation ofclozapine forcommunitybased patients

170

CLOZAPINE ADVERSE EFFECTS

175

Clozapine: common adverse effects

175

Clozapine: uncommon or unusual adverse effects

179
Clozapine: serious haematological andcardiovascular adverse effects 184

Clozapineinduced hypersalivation

189
Clozapineinduced gastrointestinal hypomotility (CIGH) 193

Clozapine, neutropenia andlithium

197

Clozapine andchemotherapy

202

Chapter 2

Bipolar disorder 205

Lithium

205

Valproate

214

Carbamazepine

221

Antipsychotic drugs inbipolar disorder

226
Antipsychotic longacting injections inbipolar disorder 229
Physical monitoring forpeople withbipolar disorder 232

Treatment ofacute mania or hypomania

235

Rapidcycling bipolar disorder

241

Bipolar depression

243

Prophylaxis inbipolar disorder

250

Contentsvii

Chapter 3

Depression andanxiety disorders 255

Depression: introduction

255

Basic principles of prescribing in depression

255

Official guidance on the treatment of depression

256

Antidepressants: general overview

257
Recognised minimum effective doses of antidepressants 262

Drug treatment of depression

264

Treatment of refractory depression: first choice

267

Treatment of refractory depression: second choice

271
Treatment of refractory depression: other reported treatments 274

Psychotic depression

278

Electroconvulsive therapy and psychotropic drugs

281

Stimulants in depression

285

Poststroke depression

290

Treatment of depression in the elderly

293
Antidepressants: alternative routes of administration 298

Antidepressant prophylaxis

306

Antidepressant discontinuation symptoms

310

Antidepressants: swapping and stopping

314

Drug interactions with antidepressants

321

Cardiac effects of antidepressants

325

Antidepressantinduced arrhythmia

329

Antidepressantinduced hyponatraemia

333

Antidepressants and hyperprolactinaemia

337

Antidepressants and diabetes mellitus

340

Antidepressants and sexual dysfunction

343

SSRIs and bleeding

347

St John"s wort

355
Antidepressants: relative adverse effects - a rough guide 358

Anxiety spectrum disorders

360
Benzodiazepines in the treatment of psychiatric disorders 373

Benzodiazepines: dependence and detoxification

377

Benzodiazepines and disinhibition

381

Chapter 4

Addictions andsubstance misuse 385

Introduction

385

Alcohol dependence

387

Opioid dependence

405

Nicotine and smoking cessation

431
Pharmacological treatment of dependence on stimulants 439

GHB and GBL dependence

442

Benzodiazepine misuse

445

Synthetic cannabinoid receptor agonists (SCRAs)

447
Interactions between ‘street drugs" and prescribed psychotropic drugs 450

Drugs of misuse - a summary

454
viiiContents

Part 2

Drug treatment of special patient groups 459

Chapter 5

Children andadolescents 461

Principles of prescribing practice in childhood and adolescence 461

Depression in children and adolescents

463

Bipolar illness in children and adolescents

471

Psychosis in children and adolescents

478

Anxiety disorders in children and adolescents

480

Obsessive compulsive disorder (OCD) in children

and adolescents 485
Posttraumatic stress disorder in children and adolescents 491

Attention deficit hyperactivity disorder

496

Autism spectrum disorder

504

Tics and Tourette"s syndrome

512
Melatonin in the treatment of insomnia in children and adolescents 517
Rapid tranquillisation (RT) in children and adolescents 521
Doses of commonly used psychotropic drugs in children and adolescents 524

Chapter 6

Prescribing inolder people 525

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