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Adherence to antipsychotic treatment

Dose for prophylaxis

How and when to stop55 30 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 A large meta-­analysis concluded that the risk of relapse with newer SGAs is similar to that associated with older drugs.3 (Note that lack of relapse is not the same as good...

Alternative views Schizophrenia and related psychoses CHAPTER 1 at least 3 weeks for oral antipsychotics or abrupt withdrawal of depot preparations).56 One analysis of incidence of relapse after switch to placebo found time to relapse to be very much longer fo...

References 32 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 References Karson C, et  al. Long-­term outcomes of antipsychotic treatment in patients with first-­episode schizophrenia: a systematic review. Neuropsychiatr Dis Treat 2016; 12:57–67....

Negative symptoms

Pharmacological treatment of negative symptoms 34 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Negative symptoms Negative symptoms in schizophrenia represent the absence or diminution of normal behaviours and functions and constitute an importa...

Summary and recommendations 36 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 RCTs have demonstrated some benefit for selegiline,65,66 pramiprexole,67 topical testosterone,68 ondansetron,69 granisetron,70 palmitoylethanolamide (an endogenous anal...

References Schizophrenia and related psychoses CHAPTER 1 References Messinger JW, et al. Avolition and expressive deficits capture negative symptom phenomenology: implications for DSM-­5 and schizophrenia research. Clin Psychol Rev 2011; 31:161–168. Foussias ...

Monitoring 40 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Monitoring Table 1.6 summarises suggested monitoring for those receiving antipsychotic medication.1 Monitoring of people taking antipsychotics is very poor in most countries.2–5 The gui...

References 42 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 References National Institute for Health and Care Excellence. Clinical Knowledge Summaries. Psychosis and schizophrenia: what monitoring is required? 2014 (last revised November 2021, ...

Relative adverse effects – a rough guide Schizophrenia and related psychoses CHAPTER 1 Relative adverse effects – a rough guide Table 1.7 provides approximate estimates of relative incidence and severity of adverse effects. It serves as a rough guide and does ...

Treatment algorithms for schizophrenia

First-episode schizophrenia Schizophrenia and related psychoses CHAPTER 1 Either: Agree the choice of antipsychotic medication with patient1 and/or carer Or, if not possible: Start second-generation antipsychotic medication (select one that is available in lon...

Relapse or acute exacerbation of schizophrenia 46 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Investigate social or psychological precipitants Provide appropriate support and/or therapy Continue usual drug treatment Add short-term sedative or ...

Relapse or acute exacerbation of schizophrenia Schizophrenia and related psychoses CHAPTER 1 Relapse or acute exacerbation of schizophrenia (adherence doubtful or known to be poor) Compliance aids (e.g. Medi-­Dose® system in the UK) are not a substitute for p...

References 48 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 References Robinson DG, et al. Psychopharmacological treatment in the RAISE-­ETP study: outcomes of a manual and computer decision support system based intervention. Am J Psychiatry 20...

First-generation antipsychotics – place in therapy