In the UK, several policies address the prescribing of psychotropic medication: the NSFs for mental health and for schizophrenia, and NICE guidance. The Trust has developed prescribing guidance and this audit aims to assess adherence to this and to assist in ensuring cost effective prescribing for the organisation. The general principles of the prescribing guidance are that patients requiring antipsychotic therapy should be receiving monotherapy treatment and all doses should be within the recommended maximum range.

An audit into the prescribing of all psychotropic medication prescribed by adult mental health services was undertaken. A total of 936 patients were included in the audit of which 643 (69%) were prescribed antipsychotics. At the time of the audit, 41% were inpatients and 59% community patients.

Most patients (65%) were receiving treatment with an oral atypical antipsychotic, the most common being olanzapine.

86.3% of patients were being treated with one antipsychotic and this is higher than figures quoted in national reports. When prescribed as monotherapy the doses are 99% within the therapeutic range. When polypharmacy occurs the doses are frequently above the recommended maximum range.

In line with the NSF for mental health and the NICE guidance for schizophrenia, it is recommended that prescribers review their prescribing. In particular, prescribers should review the treatment of patients prescribed more than one antipsychotic. As stated in the Trust prescribing guidance, prescribers should consider oral risperidone or amisulpride as first line atypical antipsychotics.