The Maudsley Prescribing Guidelines in Psychiatry

Synopsis

The Maudsley Prescribing Guidelines in Psychiatry

The new edition of the world-renowned reference guide on the use of medications for patients presenting with mental health problems

The Maudsley Prescribing Guidelines in Psychiatry is the essential evidence-based handbook on the safe and effective prescribing of psychotropic agents. Covering both common and complex prescribing situations encountered in day-to-day clinical practice, this comprehensive resource provides expert guidance on drug choice, minimum and maximum doses, adverse effects, switching medications, prescribing for special patient groups, and more. Each clear and concise chapter includes an up-to-date reference list providing easy access to the evidence on which the guidance is based.

The fourteenth edition has been fully updated to incorporate the latest available research, the most recent psychotropic drug introductions, and all psychotropic drugs currently used in the UK, USA, Canada, Australia, New Zealand, and Japan. Several new sections cover topics such as deprescribing of major psychiatric drugs, prescribing psychotropics at the end of life, the treatment of agitated delirium, the genetics of clozapine prescribing, the use of weekly penfluridol, and the treatment of psychotropic withdrawal. Featuring contributions by an experienced team of psychiatrists and specialist pharmacists, the new edition of The Maudsley Prescribing Guidelines in Psychiatry:

• Provides succinct coverage of drug treatment of psychiatric conditions and formulating prescribing policy in mental health
• Covers a wide range of psychiatric conditions including schizophrenia, bipolar disorder, depression and anxiety, borderline personality, eating disorders, and many others
• Provides advice on prescribing for children and adolescents, older people, pregnant women, and other special patient groups
• Offers new sections on genetic prescribing, long-acting injectable formulations, ketamine administration and uses, and dopamine super-sensitivity
• Includes referenced information on off-label prescribing, potential interactions with other substances such as alcohol, tobacco, and caffeine, and treating patients with comorbid physical conditions

Whether in the doctor's office, in the clinic, or on the ward, The Maudsley Prescribing Guidelines in Psychiatry, Fourteenth Edition is a must-have for psychiatrists, pharmacists, neuropharmacologists, clinical psychologists, nurses, and other healthcare professionals working in mental health, as well as trainees and students in medicine, pharmacy, and nursing.

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Summary

Chapter 1: Introduction

This chapter provides an overview of the book's purpose, scope, and target audience. It emphasizes the importance of evidence-based prescribing in psychiatry and introduces the Maudsley Prescribing Guidelines (MPG) as a comprehensive resource for clinicians.

Chapter 2: General Principles of Psychopharmacology

This chapter discusses the basic principles of psychopharmacology, including pharmacokinetics, pharmacodynamics, and the principles of rational prescribing. It emphasizes the need for individualized treatment, considering factors such as age, physical health, and drug interactions.

Example: The MPG recommends starting with a low dose of a medication and gradually increasing it as tolerated to minimize adverse effects.

Chapter 3: Antipsychotics

This chapter covers the different types of antipsychotics, their indications, adverse effects, and dosing recommendations. It discusses first-line and second-line options based on evidence and clinical experience.

Example: The MPG recommends atypical antipsychotics as first-line treatment for schizophrenia due to their better tolerability profile and equal efficacy.

Chapter 4: Antidepressants

This chapter reviews the various classes of antidepressants, their mechanisms of action, and their use in different depressive disorders. It emphasizes the importance of matching the antidepressant to the individual patient's symptoms and response.

Example: The MPG recommends selective serotonin reuptake inhibitors (SSRIs) as first-line treatment for mild to moderate depression due to their efficacy and low risk of adverse effects.

Chapter 5: Anxiolytics and Hypnotics

This chapter covers the different classes of anxiolytics and hypnotics, including benzodiazepines, non-benzodiazepine hypnotics, and buspirone. It discusses their indications, adverse effects, and precautions for use.

Example: The MPG recommends limiting the use of benzodiazepines due to their potential for dependence and abuse, and instead consider non-benzodiazepine options such as buspirone for anxiety disorders.

Chapter 6: Mood Stabilizers

This chapter provides an overview of the different classes of mood stabilizers, including lithium, anticonvulsants, and atypical antipsychotics. It discusses their indications, adverse effects, and their role in treating bipolar disorder.

Example: The MPG recommends lithium as the first-line mood stabilizer for bipolar disorder due to its long history of effectiveness and tolerability.

Chapter 7: Other Medications

This chapter covers other medications used in the treatment of psychiatric disorders, including stimulants, anticholinergics, and psychostimulants. It discusses their indications, adverse effects, and clinical considerations.

Example: The MPG recommends methylphenidate as the first-line stimulant for the treatment of attention deficit hyperactivity disorder (ADHD).

Chapter 8: Special Populations

This chapter addresses the special prescribing considerations for specific populations, such as children, adolescents, the elderly, and those with physical health conditions. It discusses age-related differences in drug metabolism and the need for individualized dosing.

Example: The MPG emphasizes the need for caution when prescribing antidepressants to children and adolescents due to the increased risk of suicidal thoughts and behaviors.