The Maudsley Prescribing Guidelines in Psychiatry

Part 1: Drug treatment of major psychiatric conditions

Chapter 1: Schizophrenia and related psychoses

ANTIPSYCHOTIC DRUGS

• General introduction
• General principles of prescribing
• Minimum effective doses
• Licensed maximum doses
• Equivalent doses
• High-dose antipsychotics: prescribing and monitoring
• Combined antipsychotics
• Antipsychotic prophylaxis
• Negative symptoms
• Monitoring
• Relative adverse effects a rough guide
• Treatment algorithms for schizophrenia
• First-generation antipsychotics place in therapy
• NICE guidelines for the treatment of schizophrenia
• Antipsychotic response to increase the dose, to switch, to add or just wait what is the right move?
• Acutely disturbed or violent behaviour
• Antipsychotic long-acting injections
• Depot antipsychotics pharmacokinetics
• Management of patients on long-term depots
• Aripiprazole long-acting injection
• Olanzapine long-acting injection
• Paliperidone palmitate long-acting injection
• Risperidone long-acting injection
• Omega-3 fatty acid (fish oils) in schizophrenia

ANTIPSYCHOTIC ADVERSE EFFECTS

• Extrapyramidal symptoms
• Akathisia
• Weight gain
• Treatment of antipsychotic-induced weight gain
• Electroconvulsive therapy and psychosis
• Neuroleptic malignant syndrome
• Catatonia
• QT prolongation
• Dyslipidaemia
• Diabetes and impaired glucose tolerance
• Blood pressure changes
• Hyponatraemia
• Hyperprolactinaemia
• Sexual dysfunction
• Pneumonia
• Switching antipsychotics
• Venous thromboembolism

REFRACTORY SCHIZOPHRENIA AND CLOZAPINE

• Clozapine initiation schedule
• Optimising clozapine treatment
• Alternatives to clozapine
• Re-starting clozapine after a break in treatment
• Initiation of clozapine for community-based patients

CLOZAPINE ADVERSE EFFECTS

• Clozapine: common adverse effects
• Clozapine: uncommon or unusual adverse effects
• Clozapine: serious haematological and cardiovascular adverse effects
• Clozapine-induced hypersalivation
• Clozapine-induced gastrointestinal hypomotility (CIGH)
• Clozapine, neutropenia and lithium
• Clozapine and chemotherapy

Chapter 2: Bipolar disorder

• Lithium
• Valproate
• Carbamazepine
• Antipsychotic drugs in bipolar disorder
• Antipsychotic long-acting injections in bipolar disorder
• Physical monitoring for people with bipolar disorder
• Treatment of acute mania or hypomania
• Rapid-cycling bipolar disorder
• Bipolar depression
• Prophylaxis in bipolar disorder

Chapter 3: Depression and anxiety disorders

Chapter 4 Addictions and substance misuse

• Introduction
• Alcohol dependence
• Opioid dependence
• Nicotine and smoking cessation
• Pharmacological treatment of dependence on stimulants
• GHB and GBL dependence
• Benzodiazepine misuse
• Synthetic cannabinoid receptor agonists (SCRAs)
• Interactions between street drugs and prescribed psychotropic drugs
• Drugs of misuse a summary

Part 2: Drug treatment of special patient groups

Chapter 5 Children and adolescents

• Principles of prescribing practice in childhood and adolescence
• Depression in children and adolescents
• Bipolar illness in children and adolescents
• Psychosis in children and adolescents
• Anxiety disorders in children and adolescents
• Obsessive compulsive disorder (OCD) in children and adolescents
• Post-traumatic stress disorder in children and adolescents
• Attention deficit hyperactivity disorder
• Autism spectrum disorders
• Tics and Tourette s syndrome
• Melatonin in the treatment of insomnia in children and adolescents
• Rapid tranquillisation (RT) in children and adolescents
• Doses of commonly used psychotropic drugs in children and adolescents

Chapter 6 Prescribing in older people

• General principles
• Dementia
• Safer prescribing for physical conditions in dementia
• Management of behavioural and psychological symptoms of dementia
• A guide to medication doses of commonly used psychotropic drugs in older adults
• Covert administration of medicines within food and drink

Chapter 7: Pregnancy and breastfeeding

• Drug choice in pregnancy
• Breastfeeding

Chapter 8: Hepatic and renal impairment

• Hepatic impairment
• Renal impairment

Part 3: Prescribing in specialist conditions

Chapter 9: Drug treatment of other psychiatric conditions

• Borderline personality disorder
• Eating disorders
• Delirium

Chapter 10: Drug treatment of psychiatric symptoms occurring in the context of other disorders

• General principles of prescribing in human immunodeficiency virus (HIV)
• Prescribing psychotropics in HIV
• Epilepsy
• Deletion syndrome
• Learning disabilities
• Huntington's disease
• Multiple sclerosis
• Parkinson's disease
• Atrial fibrillation
• Bariatric surgery

Part 4: Other aspects of psychotropic drug use

Chapter 11 Pharmacokinetics

• Plasma level monitoring of psychotropic drugs
• Interpreting post-mortem blood concentrations
• Acting on clozapine plasma concentration results
• Psychotropic drugs and cytochrome (CYP) function
• Smoking and psychotropic drugs
• Drug interactions with alcohol

Chapter 12 Other substances

• Caffeine
• Nicotine

Chapter 13: Psychotropic drugs in special conditions

• Psychotropic drugs in overdose
• Driving and psychotropic drugs
• Psychotropic drugs and surgery

Chapter 14: Miscellany

• Enhancing medication adherence
• Re-starting psychotropic medications after a period of non-compliance
• Biochemical and haematological effects of psychotropic medications
• Summary of psychiatric adverse effects of non-psychotropic medications
• Prescribing drugs outside their licensed indications ( off-label prescribing)
• The Mental Health Act in England and Wales
• Site of administration of intramuscular injections

The revised 13th edition of the essential reference for the prescribing of drugs for patients with mental health disorders

The revised and updated 13th edition of The Maudsley Prescribing Guidelines in Psychiatry provides up-to-date information, expert guidance on prescribing practice in mental health, including drug choice, treatment of adverse effects and how to augment or switch medications. The text covers a wide range of topics including pharmacological interventions for schizophrenia, bipolar disorder, depression and anxiety, and many other less common conditions. There is advice on prescribing in children and adolescents, in substance misuse and in special patient groups.

This world-renowned guide has been written in concise terms by an expert team of psychiatrists and specialist pharmacists. The Guidelines help with complex prescribing problems and include information on prescribing psychotropic medications outside their licensed indications as well as potential interactions with other medications and substances such as alcohol, tobacco and caffeine. In addition, each of the book’s 165 sections features a full reference list so that evidence on which guidance is based can be readily accessed. This important text:

• Is the world’s leading clinical resource for evidence-based prescribing in day-to-day clinical practice and for formulating prescribing policy
• Includes referenced information on topics such as transferring from one medication to another, prescribing psychotropic medications during pregnancy or breastfeeding, and treating patients with comorbid physical conditions, including impaired renal or hepatic function.
• Presents guidance on complex clinical problems that may not be encountered routinely

Written for psychiatrists, neuropharmacologists, pharmacists and clinical psychologists as well as nurses and medical trainees, The Maudsley Prescribing Guidelines in Psychiatry are the established reference source for ensuring the safe and effective use of medications for patients presenting with mental health problems.