David Taylor is Chief Pharmacist at the South London and Maudsley NHS Foundation Trust, Professor of Psychopharmacology at King's College London, and Pharmacy Lead for the UK Mental Health Research Network. The lead author of all editions of The Maudsley Prescribing Guidelines , Professor Taylor is the author of several other texts and editor of Therapeutic Advances in Psychopharmacology .

Carol Paton is Chief Pharmacist at Oxleas NHS Foundation Trust, London: she is also joint Head of the Prescribing Observatory for Mental Health and an Honorary Research Fellow at Imperial College London.

Shitij Kapur is Professor of Schizophrenia, Imaging and Therapeutics and the Dean and Head of School at the Institute of Psychiatry, King s College London.

The fully updated 12th edition of an essential reference for anyone responsible for prescribing drugs for patients with mental health disorders.

Preface xi
Acknowledgements xii
Notes on using The Maudsley Prescribing Guidelines xiii
List of abbreviations xv
Chapter 1 Plasma level monitoring of psychotropic drugs 1
Interpreting sample results 2
Acting on clozapine plasma concentration results 11
Interpreting post-mortem blood concentrations 13
Chapter 2 Schizophrenia 15
Antipsychotic drugs 15
General introduction 15
General principles of prescribing 20
Minimum effective doses 22
Quick reference for licensed maximum doses 24
Equivalent doses 26
High-dose antipsychotics: prescribing and monitoring 28
Antipsychotic prophylaxis 31
Combined antipsychotics 37
Negative symptoms 41
Monitoring 45
Relative adverse effects - a rough guide 48
Treatment algorithms for schizophrenia 49
First?]generation antipsychotics - place in therapy 52
Omega-3 fatty acid (fish oils) in schizophrenia 54
New and developing drugs to treat schizophrenia 56
NICE guidelines for the treatment of schizophrenia 59
Antipsychotic response - to increase the dose, to switch, to add or just wait - what is the right move? 61
Antipsychotic long?]acting injections 66
Depot antipsychotics - pharmacokinetics 70
Management of patients on long?]term depots 72
Aripiprazole LAI 74
Olanzapine LAI 75
Paliperidone palmitate LAI 77
Risperidone LAI 80
ANTIPSYCHOT ICS - ADVERSE EFFECTS 84
Extrapyramidal side-effects 84
Akathisia 88
Weight gain 90
Treatment of drug-induced weight gain 92
Tardive dyskinesia 97
Neuroleptic malignant syndrome 102
Catatonia 105
QT prolongation 110
Dyslipidaemia 117
Diabetes and impaired glucose tolerance 121
Hypertension 128
Hyponatraemia 130
Hyperprolactinaemia 133
Sexual dysfunction 137
Pneumonia 143
Switching antipsychotics 144
REFRACTORY SCHIZOPHRENIA AND CLOZAPINE 147
Clozapine - dosing regimen 147
Optimising clozapine treatment 149
Alternatives to clozapine 153
Restarting clozapine after a break in treatment 159
Initiation of clozapine for community-based patients 160
CLOZAPINE - ADVERSE EFFECTS 165
Common adverse effects 165
Clozapine: uncommon or unusual adverse effects 168
Clozapine: serious haematological and cardiovascular adverse effects 170
Clozapine-induced hypersalivation 174
Clozapine-induced gastrointestinal hypomotility (CIGH) 177
Clozapine, neutropenia and lithium 181
Clozapine and chemotherapy 186
Chapter 3 Bipolar affective disorder 189
Lithium 189
Valproate 197
Carbamazepine 203
Antipsychotics in bipolar disorder 208
Treatment of acute mania or hypomania 211
Bipolar depression 216
Rapid-cycling bipolar affective disorder 223
Prophylaxis in bipolar affective disorder 225
Physical monitoring for people with bipolar affective disorder 228
Chapter 4 Depression and anxiety 231
Introduction 231
Basic principles of prescribing in depression 231
Official guidance on the treatment of depression 232
Antidepressants: general overview 233
St John's wort 246
Recognised minimum effective doses of antidepressants 250
Drug treatment of depression 252
Treatment of refractory depression 255
Psychotic depression 266
Electroconvulsive therapy and psychotropic drugs 269
Psychostimulants in depression 272
Post-stroke depression 276
Treatment of depression in the elderly 279
Antidepressant discontinuation symptoms 283
Antidepressant prophylaxis 287
Antidepressants: alternative routes of administration 290
Antidepressants: swapping and stopping 296
Drug interactions with antidepressants 303
Cardiac effects of antidepressants 307
Antidepressant-induced arrhythmia 312
Antidepressant-induced hyponatraemia 316
Antidepressants and hyperprolactinaemia 319
Antidepressants and diabetes mellitus 321
Antidepressants and sexual dysfunction 324
SSR Is and bleeding 328
Antidepressants: relative adverse effects - a rough guide 332
Anxiety spectrum disorders 334
Benzodiazepines in the treatment of psychiatric disorders 343
Benzodiazepines: dependence and detoxification 346
Benzodiazepines and disinhibition 350

The fully updated 12th edition of an essential reference for anyone responsible for prescribing drugs for patients with mental health disorders.

A well-respected and widely-used source of information on which drugs to prescribe, which side effects to look out for, how best to augment or switch drugs, and more
Provides concise reviews of psychiatric disorders and relevant psychopharmacology, along with general guidance based on the data reviewed and current clinical practice
Includes specific guidance for schizophrenia, bipolar disorder, depression, anxiety, substance abuse, and special populations such as children, the elderly and pregnant women
Each section features a full reference list so the evidence base can be checked quickly and easily