Exclusive: Half of PCTs fail on antipsychotic prescribing

Over half of PCTs in England are failing to commission services to reduce antipsychotic prescribing among dementia patients, despite well-known safety risks, GP newspaper can reveal.

GPs have previously warned they are forced to prescribe the drugs because of a lack of alternative services to refer to
GPs have previously warned they are forced to prescribe the drugs because of a lack of alternative services to refer to

The findings increase pressure on the DoH to release its antipsychotics review, originally expected in spring.

Responses from 62 PCTs to a request for information by GP newspaper show 57% are failing to offer services to help GPs cut prescribing of the drugs risperidone and olanzapine.

Results of GP newspaper investigation

GPs have previously warned they are forced to prescribe the drugs, which can triple the risk of stroke and double the risk of death, because of a lack of alternative services to refer to.

The responses also show half of PCTs do not carry out audits recommended by NICE to find dementia patients suitable for treatment with acetyl-cholinesterase inhibitors, such as donepezil, rivastigmine and galantamine.

Alzheimer's Society chief executive Neil Hunt said: ‘It is a sad day when prescribing of antipsychotics is unacceptably high and prescriptions of cholinesterase inhibitors are among the lowest in Europe.

‘We must develop health and social care services that can respond to the challenge of dementia.'

North Shields GP, Dr Dave Tomson, who has an interest in mental health, said: ‘Most people now know antipsychotic prescribing is not desirable, but it still happens because of a lack of alternatives.

‘PCTs could incentivise GPs to take regular audits and reviews of antipsychotic prescribing.'

He called for better teamwork between psychiatrists, nursing homes, GPs and specialist practitioners.

A DoH spokeswoman said the anti-psychotic review would be published in November. Only ‘severely distressed' dementia patients or those putting themselves or others at risk should receive the drugs, she said.

Neil Durham

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