The Maudsley Guidelines on Advanced Prescribing in Psychosis

Part 1. Psychosis

1.1 What is psychosis?

1.2 Lack of insight

1.3 Cause of psychosis

1.4 Schizophrenia: loss of personality and psychosocial decline

1.5 Bipolar disorder

1.6 Cannabis, synthetic cannabinoids and psychosis

Part 2. Towards evidence based treatment for psychosis

2.1 Traditional medicine

2.2 The randomized controlled trial

2.3 The roots of community care

2.4 Treatment algorithms versus personalized care

Part 3. The antipsychotics

3.1 General principles in the pharmacology of psychosis

3.2 Neurotransmitters and receptors

3.3 Choosing drugs

3.4 Acute psychotic episodes

3.5 The maintenance phase: Relapse Prevention

3.6 The utility of long-acting depot antipsychotics

3.7 Principles of long-acting depot antipsychotic prescribing

3.8.1 Clozapine for treatment refractory patients

3.8.2 Clozapine resistant psychosis

3.8.3 Side effects of clozapine

Part 4. Bipolar disorder

4.1 Diagnosis of bipolar

4.2 Treatment of mania

4.3 Treatment of bipolar depression

4.4 The maintenance phase of bipolar: Relapse Prevention

4.5 Bipolar in females of childbearing age

Part 5. The role of talking therapies in the treatment of psychosis

5.1 Psychoanalytical insights

5.2 Psychological treatments

Part 6. Side effects of antipsychotic treatment

6.1 Weight gain

6.2 Type II diabetes

6.3 Dyslipidemia

6.4 Motor side-effects

6.5 Hyperprolactinemia

6.6 Sexual side effects

6.7 Prolonged QTc

6.8 Neuroleptic malignant syndrome

Part 7. Services: Pathway specific care

7.1 The at-risk-mental-state

7.2 Early intervention services

7.3 Acute services

7.4 Continuing care: Promoting recovery

Part 8. Measuring outcomes

8.1 Value-based healthcare

8.2 Evidence-based healthcare management

The goal for this text is to emphasize that treatment of psychosis must be tailored to the needs of individual patients. While a given diagnosis may suggest principle mechanisms under prescription guidelines, standard treatment of psychosis is unfeasible due to no two patients suffering from an identical illness. This text therefore aims to contrast the one-size-fits-all treatment that general medicine has taken for granted, and instead focuses on building psychiatrist and patient relationships to foster individual treatment plans.