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The Maudsley Prescribing Guidelines in Psychiatry
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Main description:

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.


Preface x

Acknowledgements xii

Notes on using The Maudsley Prescribing Guidelines in Psychiatry xiii

List of abbreviations xv

Part 1 Drug treatment of major psychiatric conditions 1

Chapter 1 Schizophrenia and related psychoses 3


General introduction 3

General principles of prescribing 8

Minimum effective doses 9

Licensed maximum doses 12

Equivalent doses 14

High?dose antipsychotics: prescribing and monitoring 16

Combined antipsychotics 20

Antipsychotic prophylaxis 25

Negative symptoms 31

Monitoring 36

Relative adverse effects - a rough guide 39

Treatment algorithms for schizophrenia 40

First?generation antipsychotics - place in therapy 44

NICE guidelines for the treatment of schizophrenia 46

Antipsychotic response - to increase the dose, to switch, to add or just wait - what is the right move? 49

Acutely disturbed or violent behaviour 54

Antipsychotic depots/long?acting injections (LAIs) 66

Depot/LAI antipsychotics - pharmacokinetics 71

Management of patients on long?term depots/LAIs 73

Aripiprazole long?acting injection 75

Olanzapine long?acting injection 77

Paliperidone palmitate long?acting injection 79

Risperidone long?acting injection 82

Electroconvulsive therapy and psychosis 86

Omega?3 fatty acid (fish oils) in schizophrenia 88


Extrapyramidal symptoms 90

Akathisia 94

Weight gain 97

Treatment of antipsychotic?induced weight gain 99

Neuroleptic malignant syndrome 104

Catatonia 107

ECG changes - QT prolongation 112

Effect of antipsychotic medications on plasma lipids 119

Diabetes and impaired glucose tolerance 123

Blood pressure changes 130

Hyponatraemia 134

Hyperprolactinaemia 137

Sexual dysfunction 141

Pneumonia 148

Switching antipsychotics 150

Venous thromboembolism 153


Clozapine initiation schedule 156

Optimising clozapine treatment 158

Alternatives to clozapine 162

Re?starting clozapine after a break in treatment 169

Initiation of clozapine for community?based patients 170


Clozapine: common adverse effects 175

Clozapine: uncommon or unusual adverse effects 179

Clozapine: serious haematological and cardiovascular adverse effects 184

Clozapine?induced hypersalivation 189

Clozapine?induced gastrointestinal hypomotility (CIGH) 193

Clozapine, neutropenia and lithium 197

Clozapine and chemotherapy 202

Chapter 2 Bipolar disorder 205

Lithium 205

Valproate 214

Carbamazepine 221

Antipsychotic drugs in bipolar disorder 226

Antipsychotic long?acting injections in bipolar disorder 229

Physical monitoring for people with bipolar disorder 232

Treatment of acute mania or hypomania 235

Rapid?cycling bipolar disorder 241

Bipolar depression 243

Prophylaxis in bipolar disorder 250

Chapter 3 Depression and anxiety disorders 255

Depression: introduction 255

Basic principles of prescribing in depression 255

Official guidance on the treatment of depression 256

Antidepressants: general overview 257

Recognised minimum effective doses of antidepressants 262

Drug treatment of depression 264

Treatment of refractory depression: first choice 267

Treatment of refractory depression: second choice 271

Treatment of refractory depression: other reported treatments 274

Psychotic depression 278

Electroconvulsive therapy and psychotropic drugs 281

Stimulants in depression 285

Post?stroke depression 290

Treatment of depression in the elderly 293

Antidepressants: alternative routes of administration 298

Antidepressant prophylaxis 306

Antidepressant discontinuation symptoms 310

Antidepressants: swapping and stopping 314

Drug interactions with antidepressants 321

Cardiac effects of antidepressants 325

Antidepressant?induced arrhythmia 329

Antidepressant?induced hyponatraemia 333

Antidepressants and hyperprolactinaemia 337

Antidepressants and diabetes mellitus 340

Antidepressants and sexual dysfunction 343

SSRIs and bleeding 347

St John's wort 355

Antidepressants: relative adverse effects - a rough guide 358

Anxiety spectrum disorders 360

Benzodiazepines in the treatment of psychiatric disorders 373

Benzodiazepines: dependence and detoxification 377

Benzodiazepines and disinhibition 381

Chapter 4 Addictions and substance misuse 385

Introduction 385

Alcohol dependence 387

Opioid dependence 405

Nicotine and smoking cessation 431

Pharmacological treatment of dependence on stimulants 439

GHB and GBL dependence 442

Benzodiazepine misuse 445

Synthetic cannabinoid receptor agonists (SCRAs) 447

Interactions between 'street drugs' and prescribed psychotropic drugs 450

Drugs of misuse - a summary 454

Part 2 Drug treatment of special patient groups 459

Chapter 5 Children and adolescents 461

Principles of prescribing practice in childhood and adolescence 461

Depression in children and adolescents 463

Bipolar illness in children and adolescents 471

Psychosis in children and adolescents 478

Anxiety disorders in children and adolescents 480

Obsessive compulsive disorder (OCD) in children and adolescents 485

Post?traumatic stress disorder in children and adolescents 491

Attention deficit hyperactivity disorder 496

Autism spectrum disorder 504

Tics and Tourette's syndrome 512

Melatonin in the treatment of insomnia in children and adolescents 517

Rapid tranquillisation (RT) in children and adolescents 521

Doses of commonly used psychotropic drugs in children and adolescents 524

Chapter 6 Prescribing in older people 525

General principles 525

Dementia 529

Safer prescribing for physical conditions in dementia 570

Management of behavioural and psychological symptoms of dementia 557

A guide to medication doses of commonly used psychotropic drugs in older adults 586

Covert administration of medicines within food and drink 593

Chapter 7 Pregnancy and breastfeeding 599

Drug choice in pregnancy 599

Breastfeeding 619

Chapter 8 Hepatic and renal impairment 635

Hepatic impairment 635

Renal impairment 645

Part 3 Prescribing in specialist conditions 661

Chapter 9 Drug treatment of other psychiatric conditions 663

Borderline personality disorder 663

Eating disorders 667

Delirium 672

Chapter 10 Drug treatment of psychiatric symptoms occurring in the context of other disorders 679

General principles of prescribing in human immunodeficiency virus (HIV) 679

Prescribing psychotropics in HIV 685

Epilepsy 688

22q11.2 Deletion syndrome 696

Learning disabilities 699

Huntington's disease 704

Multiple sclerosis 709

Parkinson's disease 715

Atrial fibrillation 719

Bariatric surgery 722

Part 4 Other aspects of psychotropic drug use 729

Chapter 11 Pharmacokinetics 731

Plasma level monitoring of psychotropic drugs 731

Interpreting post?mortem blood concentrations 742

Acting on clozapine plasma concentration results 744

Psychotropic drugs and cytochrome (CYP) function 746

Smoking and psychotropic drugs 750

Drug interactions with alcohol 753

Chapter 12 Other substances 759

Caffeine 759

Nicotine 765

Chapter 13 Psychotropic drugs in special conditions 769

Psychotropic drugs in overdose 769

Driving and psychotropic drugs 776

Psychotropic drugs and surgery 781

Chapter 14 Miscellany 787

Enhancing medication adherence 787

Re?starting psychotropic medications after a period of non?compliance 794

Biochemical and haematological effects of psychotropic medications 798

Summary of psychiatric adverse effects of non?psychotropic medications 808

Prescribing drugs outside their licensed indications ('off?label' prescribing) 813

The Mental Health Act in England and Wales 816

Site of administration of intramuscular injections 821

Index 825


ISBN-13: 9781119442608
Publisher: John Wiley & Sons Ltd (Wiley-Blackwell)
Publication date: May, 2018
Pages: 872
Weight: 1242g
Availability: Contact supplier
Subcategories: Pharmacology, Psychiatry


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