12 - References

References

938 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 14 length of time. The drugs in the middle column are thought to be safe because the maximum dose is usually no higher than the highest recommended starting dose. The drugs in the right-­hand column are thought to be safe to restart at the prior dose because a similar drug appears in the middle column, because clinical experience suggests they are safe or because the risks associated with giving untitrated high doses are thought to be low. Some suggestions are obtained from EU regulatory documents (SPCs),2 while others are mere suggestions based on clinical experience. If the gap in oral treatment is longer than 2 weeks, start as if it is new treatment (noting the exceptions listed earlier). References

1. Aurobindo Pharma-­Milpharm Ltd. Summary of product characteristics. Lamotrigine 25mg tablets. 2024 (last accessed September 2024); https://www.medicines.org.uk/emc/product/4736/smpc.
2. EMC. Summaries of Product Characteristics. 2024 (last accessed September 2024); https://www.medicines.org.uk/emc/. Table 14.4  Restarting medication up to 2 weeks after stopping oral treatment. Drugs that require re-­titration Drugs that are usually safe for restarting at the previous dose Drugs that are possibly safe for restarting at the previous dose Drug Time after which re-­titration must be performed Further guidance Clozapine 48 hours See section in Chapter 1 Acamprosate Asenapine Fluoxetine Haloperidol Isocarboxazid Lofepramine Methylphenidate Phenelzine Sulpiride Tranylcypromine Valproate Antipsychotics (exceptions in column 1) Carbamazepine (beware loss on enzyme induction) Cholinesterase inhibitors CNS stimulants Disulfiram Lithium (titration advised if renal function has changed) MAOIs Memantine Naltrexone Pregabalin SSRIs Lamotrigine 3–7 days See text Methadone, buprenorphine 3 days See section in Chapter 4 Paliperidone long-­acting injection Depends on formulation See section in Chapter 1 Aripiprazole long-­acting injection Depends on formulation See section in Chapter 1 Quetiapine Suggest 1 week Tolerance to sedative and hypotensive effects may be lost Risperidone Suggest 1 week Tolerance to hypotensive effects may be lost Tricyclics Suggest 1 week Tolerance to sedative and hypotensive effects may be lost MAOIs, monoamine oxidase inhibitors.