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Effects of antidepressant drugs 428 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 3 and may also be beneficial in paraphilias.27 The short-­acting SSRI dapoxetine is an effective treatment for premature ejaculation and is licensed for this indicat...

Post-SSRI sexual dysfunction

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...

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 ...

Alcohol dependence

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...

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...

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...

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...

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...

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 ...

Children and adolescents

Older adults

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 ...

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...

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...

Opioid dependence

Prescribing for opioid dependence