Abstract
Using a case note study, this paper presents a longitudinal survey of the effect of psychiatric inpatient care on benzodiazepine prescribing. Standards were proposed to assess the quality of this prescribing. Based on these standards, the study shows inappropriate use of benzodiazepines. Following admission, there was an increase in the number of patients prescribed benzodiazepines and in the number of benzodiazepines prescribed. Of the benzodiazepines withdrawn, most were contrary to the proposed standard. The quality of drug history showed little emphasis being placed on rationalising benzodiazepine prescribing. The issue of how benzodiazepines should be handled during psychiatric admission is discussed.
Highlights
To address the issue of improving benzodiaze pine prescribing, there have been a number of professional guidelines issued. These are mainly based on consensus views and advise that benzodiazepines are only indicated for severe symptoms and, if prescribed, should be at the lowest effective dose and on a short-term basis. Examples of such guidelines are those of the Committee on Safety of Medicine (1988) and, more recently, those expressed in a report by the National Medical Advisory Committee (1994) on The Management of Anxiety and Insomnia
The combination consisted of an hypnotic and an anxiolytic
Admission to hospital may provide an opportunity to rationalise benzo diazepine prescribing in collaboration with pa tient and general practitioner. This should be based on locally agreed guidelines, as promoted by the National Medical Advisory Committee (1994), and further practice should be subjected to audit
Summary
There was no correlation between the occur raenndce poartiennutms'ber geonferraapl id dtirsasnaqtiusiflalcistaiotinon secvoernests. Side-effects from potent antipsychotic drugs used in rapid tranquillisation incidents did not seem to influence dissatisfaction, rapid tranquillisation was significantly associated with higher total side-effects over the patient stay. Within those groups who received rapid tran quillisation the polypharmacy group who re ceived a number of different antipsychotics had significantly raised side-effects compared with those receiving monotherapies. Either with shortacting haloperidol or intermediate-acting zuclopenthixol acetate alone. Better prescribing habits avoiding antipsychotic polypharmacy in rapid tranquil lisation should be encouraged
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