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01 - Introduction
Introduction The Maudsley® Prescribing Guidelines in Psychiatry, Fifteenth Edition. David M. Taylor, Thomas R. E. Barnes and Allan H. Young. © 2025 David M. Taylor. Published 2025 by John Wiley & Sons Ltd. Chapter 4 Introduction Mental and behavioural problems...
02 - References
References 478 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 ■ ■evidence of tolerance ■ ■neglect of alternative interests ■ ■persistent use despite harm. Substance use disorders should generally be treated with a combination of psychosocial and ...
03 - Alcohol dependence
Alcohol dependence
04 - Assessment and brief structured intervention
Assessment and brief structured intervention Addictions and substance misuse CHAPTER 4 Alcohol dependence In the UK 1 unit of alcohol is 10mL of ethanol or 1L of 1% alcohol. For example, 250mL of wine that is 10% alcohol contains 2.5 units. In the USA, one dri...
05 - Alcohol withdrawal
Alcohol withdrawal 480 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 The following structured assessment tools are recommended:2 ■ ■The Alcohol Use Disorders Identification Test (AUDIT)4 questionnaire is a 10-item questionnaire which is useful...
06 - Pharmacologically assisted withdrawal (alcoho
Pharmacologically assisted withdrawal (alcohol detoxification) 482 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Pharmacologically assisted withdrawal (alcohol detoxification) Alcohol withdrawal is associated with significant morbidity and morta...
07 - Wernickes encephalopathy
Wernicke’s encephalopathy Addictions and substance misuse CHAPTER 4 Carbamazepine is an alternative to a benzodiazepine for managing withdrawal in situations where benzodiazepines are not a safe first-line option.15,16 Examples include: ■ ■A history of advers...
08 - Relapse prevention
Relapse prevention Addictions and substance misuse CHAPTER 4 Relapse prevention There is no place for the continued use of benzodiazepines beyond treatment of the acute alcohol withdrawal syndrome. Acamprosate and supervised disulfiram are licensed in some cou...
09 - Pregnancy and alcohol use
Pregnancy and alcohol use 492 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Baclofen Baclofen is a GABA-B agonist that does not have a licence for use in alcohol dependence but is nevertheless used by some clinicians as second-line treatment ...
10 - Children and adolescents
Children and adolescents
11 - Older adults
Older adults
12 - Concurrent alcohol and substance use disorder
Concurrent alcohol and substance use disorders Addictions and substance misuse CHAPTER 4 healthcare professionals and likes to follow up on pregnancies that require alcohol detoxification. Specialist advice should always be sought. (See also Chapter 7.) No ...
13 - Comorbid mental health disorders in AUD
Comorbid mental health disorders in AUD 494 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Coexisting alcohol and nicotine dependence Encourage individuals to stop smoking. Refer for smoking cessation in primary care and other settings. In in-pa...
14 - References
References 496 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 optimised11 and clozapine may be considered. However, there is insufficient evidence to recommend the use of any one antipsychotic medication over another in AUD. Antipsychotics do no...
15 - Opioid dependence
Opioid dependence
16 - Prescribing for opioid dependence
Prescribing for opioid dependence
17 - Treatment of opioid overdose
Treatment of opioid overdose 498 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Opioid dependence Prescribing for opioid dependence The treatment of opioid dependence is a rapidly changing and dynamic field. A decade or so ago, maintenance treatm...
18 - Opioid substitution treatment (OST)
Opioid substitution treatment (OST) 500 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 4 Opioid substitution treatment (OST) The mainstay of pharmacological management of opioid dependence is OST. OST can be prescribed for detoxification, that is, ...