GPs were urged last year to review patients with dementia taking antipsychotics, and cut inappropriate prescribing by April 2012.
The DH had vowed to reduce prescriptions by two-thirds by November 2011, but missed its target. The MHRA has warned that the drugs continue to be used in first-line care, rather than as an alternative when other options have failed.
In a drug safety briefing, the MHRA said there had been ‘an encouraging overall reduction’ in prescribing since 2007. But it added: ‘Further work is needed to change prescribing habits as the reductions identified to date fall short of the hoped- for levels.’
GPs should consider whether prescribing antipsychotics is appropriate, it said. Patients taking the drugs must be reviewed to find out why they were prescribed.
GPs should then consult patients, their family and carers, and clinical specialists such as those in psychiatry. These discussions should aim to establish ‘whether it is safe to begin discontinuing their use and what access to alternatives is available’, the MHRA said.
The NHS Information Centre is carrying out an England-wide survey of antipsychotic prescribing for dementia. The MHRA said local information on prescribing patterns would also play an important part in driving changes in practice.