Neuroleptic prescribing in an adolescent psychiatric in-patient unit

Use of antipsychotics by child and adolescent psychiatrists

Aims and methods

A postal questionnaire of Trent Region's consultant child and adolescent psychiatrists was used to investigate the two-year period prevalence rates of antipsychotic medication prescription, and the ICD–10 psychiatric disorders it was used to treat.

Results

The response rate was good (92.3%) and 78% of respondents had prescribed antipsychotic medication for a range of conditions over the period, albeit very infrequently. Antipsychotics were used for a range of psychotic and non-psychotic disorders. The older antipsychotic agents (thioridazine, chlorpromazine and haloperidol) comprised the bulk of prescriptions. Newer, atypical, antipsychotics were prescribed only four times over the period and no patients in residential in-patient units received this form of treatment.

Clinical implications

These results highlight a pressing need to address antipsychotic prescribing in children and adolescents and, especially, the role of new antipsychotic drugs.

Use of psychotropic medication in an adolescent in-patient unit

In January 1991, the adolescent in-patient unit in Leeds became a seven-day residential unit. This study set out to review the first five years' intake of patients, with regard to basic demographic details, diagnoses, use of regularly prescribed psychotropic medication and episode length. Using clinical case notes as the primary data source, we reviewed 154 completed patient episodes, representing 128 patients. The study revealed that about a third of patients had been prescribed regular psychotropic medication, and that this group had significantly longer episodes and were significantly more likely to return to the unit than those for whom there had not been regularly prescribed medication.