The Psychiatrist (2010) 34: 44-46. doi: 10.1192/pb.bp.108.020776
© 2010 The Royal College of Psychiatrists
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Polypharmacy and high-dose antipsychotic regimes in the community{dagger}

Tongeji E. Tungaraza1

Tongeji E. Tungaraza is Consultant Psychiatrist, Wolverhampton PCT NHS Trust, Steps to Health, Wolverhampton.

Seema Gupta2

Seema Gupta is Specialist Registrar in Psychiatry at Wrexham Maelor Hospital, Wrexham.

Jane Jones2

Jane Jones works for North East Wales NHS Trust at Wrexham Maelor Hospital, Wrexham.

Rob Poole3

Rob Poole is Professor of Mental Health, Glyndwr University, Wrexham.

Gary Slegg4

Gary Slegg is Research Fellow at the Section of Psychological Medicine, Academic Unit, Wrexham.

Declaration of interest T.E.T. accepted sponsorship to attend conferences from Janssen-Cilag, Eli Lilly, Bristol-Myers Squibb and Otsuka Pharmaceuticals. R.P. has accepted speakers’ fees from Lundbeck, Eli Lilly and Pfizer, and accepted sponsorship to attend conferences from Wyeth, Astra Zeneca and Eli Lilly.

{dagger} See editorial, pp. 41-43, and review article, pp. 58-62, this issue.

1 Wolverhampton PCT NHS Trust, Steps to Health, Wolverhampton

2 North East Wales NHS Trust, Wrexham Maelor Hospital, Wrexham

3 Glyndwr University, Wrexham

4 Section of Psychological Medicine, Academic Unit, Wrexham

Correspondence: Correspondence to Tongeji E. Tungaraza (eliphaz{at}doctors.org.uk)

Aims and method To determine the pattern of psychotropic prescribing in a group of people with psychosis who were living in the community under community mental health team (CMHT) care. Case-note entries over the previous 12 months were examined.

Results Only a third of individuals were on one psychotropic medication. Atypical antipsychotics were prescribed to 80.6%. Polypharmacy was common. A third of people were taking three or more psychotropic drugs and 13.7% were on high-dose regimes, mostly involving two atypical antipsychotics.

Clinical implications The use of atypicals has not eliminated polypharmacy or high-dose antipsychotic regimes. Clinicians need to be aware of this long-standing problem.


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