Skip Navigation

Acute Episode [62]

Click the underlined text for further information

Principles of Treatment

 

 
Ensure Confidentiality at all times
Include written material
Ensure Culturally Appropriate
Check with Care Coordinator, notes or GP
Provide comprehensive care plan for multi-disciplinary approach
Clinical, emotional and social needs

 

Discuss antipsychotics with service user and decide jointly on which to use

Use lower end of standard dose range in BNF
If a conventional antipsychotic is chosen:
  • Use 300 - 1000mg chlorpromazine equivalents per day for > 6 weeks
  • use minimum effective dose
  • Don't use loading doses of antipsychotics
  • Don't prescribe antipsychotics for concurrent use except to cover short changeover periods

 

Monitor Regularly

Clinical Response
If inadequate response
 
   
Consider changing class
 
  • EPS/akathisia
  • Weight gain/diabetes
  • Sexual Dysfunction
  • Lethargy
  • Effects on eyes
 
 
  If antipsychotic is tolerable If unacceptable side effects emerge with conventional antipsychotic Consider an atypical antipsychotic
 
  Don't change drug
 
Marked behavioural disturbance See Rapid tranquillisation algorithm

 

Towards end of acute episode

 

 
  • Offer service user the opportunity to give his/her account of the illness written in the case notes
  • Enable service user to discuss his/her experiences
  • Enable carers to discuss their experiences
   
Include occupational potential and opportunity

Assess and plan for psychological intervention

  • Family Interventions, or
  • CBT
   
Medication Advice