Postcode prescribing for schizophrenia.

Clinical Excellence (NICE) issued guidance Clinical Excellence (NICE) issued guidance on the use of new (atypical) antipsychotic on the use of new (atypical) antipsychotic drugs in the treatment of schizophrenia in drugs in the treatment of schizophrenia in England and Wales (National Institute for England and Wales (National Institute for Clinical Excellence, 2002). The guidance Clinical Excellence, 2002). The guidance had a notional implementation time of had a notional implementation time of 3 months, and carries the expectation that 3 months, and carries the expectation that health professionals take it fully into health professionals take it fully into account when exercising their clinical account when exercising their clinical judgement. The guidance itself is set out judgement. The guidance itself is set out in ten brief points. In summary: the choice in ten brief points. In summary: the choice of drug needs to be made after informed of drug needs to be made after informed discussion with patient, carer and clinician, discussion with patient, carer and clinician, with the default that new atypical anti-with the default that new atypical anti-psychotic agents are the drugs of choice psychotic agents are the drugs of choice and need to be considered as first-line treat-and need to be considered as first-line treatments ; clinicians and teams need to start ments; clinicians and teams need to start assessing systematically clinical progress assessing systematically clinical progress and side-effects, as well as risk of non-and side-effects, as well as risk of non-concordance; depot drug treatment should concordance; depot drug treatment should be used where needed, but there should be be used where needed, but there should be no concurrent prescribing of atypical and no concurrent prescribing of atypical and typical drugs; clozapine has the clearest typical drugs; clozapine has the clearest efficacy advantages over conventional efficacy advantages over conventional drugs, is resource-saving and should be drugs, is resource-saving and should be used at the earliest opportunity, after fail-used at the earliest opportunity, after failure of adequate response to two prior anti-ure of adequate response to two prior anti-psychotics each given for 6–8 weeks. psychotics each given for 6–8 weeks. Overall, this Overall, this guidance has been welcomed guidance has been welcomed by user groups, carers, clinicians and the by user groups, carers, clinicians and the pharmaceutical industry. pharmaceutical industry. The guidance has emerged against a The guidance has emerged against a background of debate about the benefits background …