Experience of thioridazine use before and after the Committee on Safety of Medicines warning

2003 ◽  
Vol 27 (3) ◽  
pp. 87-89 ◽  
Author(s):  
Tim Matthews ◽  
Sian Nersy Weston
Keyword(s):  
Adverse Events ◽  
Learning Disability ◽  
Drug Withdrawal ◽  
Drug Dosage ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Before And After ◽  
Adults With Learning Disabilities ◽  
Severe Degree

Aims and MethodTo describe the use of thioridazine in a population of adults with learning disabilities at the time of the warning issued by the Committee on Safety of Medicines (CSM). Also, to observe the result of discontinuation of thioridazine and to examine factors that were associated with adverse events. Retrospective case note analysis was carried out for a sample of individuals with a learning disability.ResultsOver 50% of those on regular thioridazine experienced adverse events during or following drug withdrawal. Adverse events were significantly associated with the duration of previous thioridazine prescription. Higher drug dosage and a more severe degree of learning disability may also be factors linked to poorer outcomes.Clinical ImplicationsMore caution may be required when reducing or withdrawing antipsychotic medication in this patient group.

scholarly journals Experience of thioridazine use before and after the Committee on Safety of Medicines warning

2003 ◽  
Vol 27 (03) ◽  
pp. 87-89
Author(s):  
Tim Matthews ◽  
Sian Nersy Weston
Keyword(s):  
Adverse Events ◽  
Learning Disability ◽  
Drug Withdrawal ◽  
Drug Dosage ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Before And After ◽  
Adults With Learning Disabilities ◽  
Severe Degree

Aims and Method To describe the use of thioridazine in a population of adults with learning disabilities at the time of the warning issued by the Committee on Safety of Medicines (CSM). Also, to observe the result of discontinuation of thioridazine and to examine factors that were associated with adverse events. Retrospective case note analysis was carried out for a sample of individuals with a learning disability. Results Over 50% of those on regular thioridazine experienced adverse events during or following drug withdrawal. Adverse events were significantly associated with the duration of previous thioridazine prescription. Higher drug dosage and a more severe degree of learning disability may also be factors linked to poorer outcomes. Clinical Implications More caution may be required when reducing or withdrawing antipsychotic medication in this patient group.

scholarly journals Systemic adverse events after screening of retinopathy of prematurity with mydriatic

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256878
Author(s):  
Shumpei Obata ◽  
Taku Imamura ◽  
Masashi Kakinoki ◽  
Takahide Yanagi ◽  
Yoshihiro Maruo ◽  
...  
Keyword(s):  
Body Weight ◽  
Adverse Events ◽  
Retinopathy Of Prematurity ◽  
Case Series ◽  
Abdominal Distension ◽  
Abdominal Distention ◽  
Retrospective Case ◽  
Lower Body Weight ◽  
Case Series Study ◽  
Before And After

Purpose To evaluate systemic adverse events after screening for retinopathy of prematurity (ROP) performed with mydriatic. Methods This was a retrospective case series study. Medical records of consecutive patients who underwent screening for ROP with 0.5% phenylephrine and 0.5% tropicamide eyedrops were retrospectively reviewed. The score of abdominal distention (0–5), volume of milk sucked and volume of stool, along with systemic details (pulse and respiration rates, blood pressure and number of periods of apnea) were collected at 1 week and 1 day before ROP examination, and at 1 day after examination. Results were compared between the days before and after examination. Correlation between body weight at the time of examination and the score of abdominal distention was examined. The numbers of infants with abdominal and/or systemic adverse events were compared between pre- and post-examination periods. Results Eighty-six infants met the inclusion criteria. The score of abdominal distention increased from 2.0 at 1 day before examination to 2.3 at 1 day after examination (p = 0.005), and the number of infants who had worsened abdominal distension increased after examination (p = 0.01). Infants with lower body weight had a higher score of abdominal distention (p < 0.0001, r = −0.57). The number of infants with reduced milk consumption increased after examination (p = 0.0001), as did the number of infants with decreased pulse rate (p = 0.0008). Conclusions Screening for ROP with mydriatic may have adverse effects on systemic conditions. Infants should be carefully monitored after ROP screening with mydriatic.

scholarly journals Patients with learning disability at Kneesworth House Hospital

1998 ◽  
Vol 22 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Deborah Brooke
Keyword(s):  
Learning Disability ◽  
Clinical Characteristics ◽  
Psychiatric Morbidity ◽  
Case Note ◽  
Challenging Behaviour ◽  
Retrospective Case

This paper reports a retrospective case note study of all patients with learning disability and challenging behaviour admitted to Kneesworth House Hospital between 1986 and 1991 (n=70), describing their demographic and clinical characteristics. The subjects had high levels of psychiatric morbidity, in addition to learning disability. Patients whose stay was relatively short, or who were discharged to community placements, were not able to be differentiated on clinical grounds, suggesting that the provision of local facilities determined the length of the admission. There is a need for more regional and sub-regional services for this group with multiple long-term problems.

Parasuicide and Appendicectomy

1988 ◽  
Vol 152 (5) ◽  
pp. 706-709 ◽  
Author(s):  
Christopher A. Vassilas
Keyword(s):  
Young Women ◽  
Case Note ◽  
Index Admission ◽  
Normal Appendix ◽  
Retrospective Case ◽  
Before And After

A retrospective case-note study of young women admitted for appendicectomy showed that in those patients who had a normal appendix removed, there was a significantly higher rate of admission for parasuicide, before and after the index admission; 27/184 (∼15%) compared with 17/368 (∼5%) for patients who had an inflamed appendix removed.

scholarly journals High dose neuroleptics – who gives them and why?

2001 ◽  
Vol 25 (5) ◽  
pp. 179-183 ◽  
Author(s):  
Alcuin Wilkie ◽  
Neil Preston ◽  
Roger Wesby
Keyword(s):  
Case Note ◽  
Clinical Implications ◽  
High Dose ◽  
Retrospective Case ◽  
Cross Sectional ◽  
History Of ◽  
Relationship Of ◽  
The Relationship ◽  
Higher Doses ◽  
Current Behaviour

Aims and MethodNeuroleptic medication is often used in excess of the BNF maximum. The purpose of this study was to examine the relationship of neuroleptic dose to patient, prescriber and environmental factors, by using a cross sectional ‘snapshot’ study of psychiatric in-patient prescriptions combined with a retrospective case note survey.ResultsIt was found that certain consultants prescribe higher doses of neuroleptics than others. Patients with a history of aggression had a nine and a half times higher chance of being prescribed higher doses of neuroleptics. Patients with a greater than 5-year history of neuroleptic prescription received higher doses.Clinical ImplicationsHigh neuroleptic prescription is related more to patients' past reputation and prescriber differences than to patients' current behaviour.

scholarly journals Access to a child mental health service

2002 ◽  
Vol 26 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Graeme Lamb ◽  
Anita Anfield ◽  
Anne Sheeran
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Child Mental Health ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Consultation Service ◽  
Child Mental Health Service ◽  
Initial Appointment

Aims and MethodThis was a retrospective case note analysis of all referrals to an inner-London child and family consultation service aiming to examine any changes in patterns of referral and attendance of Bangladeshi and indigenous families over the previous 10-year period.ResultsBangladeshi referrals increased over the period but remained under-represented compared to indigenous families. They were less likely to attend an initial appointment, but once engaged with the service dropout rates were unaffected by ethnicity.Clinical ImplicationsImproved communication between the department, families and referrers may help to increase understanding of the function of the department and lead to more equitable uptake of services in the future.

scholarly journals Locked ward patients 25 years on

1998 ◽  
Vol 22 (10) ◽  
pp. 608-609
Author(s):  
Martin Feakins
Keyword(s):  
Cross Section ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
The Past ◽  
The Future

Aims and methodA retrospective case note study of 43 patients who were residents of a locked ward in 1970, augmented by a cross-section of the ward's current residents was undertaken.ResultsThe study established a profile of the 43 patients in 1970 and determined their outcomes. A brief comparison of the use of medication then and now was also undertaken.Clinical implicationsThis view of the past aimed to provide a prospective on why and how the field has changed, and to facilitate planning for the future.

scholarly journals Changes in practice of ECT: a follow-on study

1998 ◽  
Vol 22 (11) ◽  
pp. 687-690 ◽  
Author(s):  
Kate Trezise
Keyword(s):  
Electroconvulsive Therapy ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Risk Of Treatment

Aims and methodA retrospective case note study examining the effects of increased supervision on practice of electroconvulsive therapy (ECT).ResultsIncreasing the level of supervision of ECT sessions was associated with patients receiving on average almost two fewer treatment applications per course of ECT.Clinical implicationsThe risk of treatment is reduced because patients receive fewer anaesthetics, and they may be discharged home sooner. Such improvements in ECT practice should be relatively easily achievable in many ECT clinics.

scholarly journals New long-stay patients in a psychiatric admission ward setting

2005 ◽  
Vol 29 (12) ◽  
pp. 452-454 ◽  
Author(s):  
Colin Cowan ◽  
Philippa Walker
Keyword(s):  
Patient Care ◽  
Descriptive Study ◽  
Case Note ◽  
Living Alone ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Psychiatric Admission ◽  
Admission Ward ◽  
Early Readmission ◽  
Case Note Review

Aims and MethodThis is a descriptive study of the admissions of new long-stay patients and their outcome in a district with minimal access to longer-stay in-patient beds. Cases were identified through an ongoing in-patient census and information was gathered by retrospective case-note review.ResultsThirty-nine new long-stay admissions were identified. High rates of living alone, early readmission following previous discharge and use of the Mental Health Act 1983 were noted. The 39 admissions occupied 12% of the unit's capacity. Four patients returned to a family residence but 27 went into residential or in-patient care. Of those discharged to settings not providing patient care, 48% were readmitted in the year after discharge.Clinical ImplicationsNew long-stay admissions continue to absorb a high proportion of the bed resources of an in-patient unit for their numbers and these patients are at risk of unsuccessful discharge.

scholarly journals Continuity of supply of psychiatric medicines for newly received prisoners

2011 ◽  
Vol 35 (7) ◽  
pp. 244-248 ◽  
Author(s):  
Lamiece Hassan ◽  
Jane Senior ◽  
Dawn Edge ◽  
Jenny Shaw
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Clinical Assessment ◽  
Mental Health Policy ◽  
Case Note ◽  
Additional Stress ◽  
Clinical Implications ◽  
Psychiatric Medication ◽  
Retrospective Case ◽  
Case Note Review

Aims and methodA retrospective case-note review was undertaken at five English prisons between June 2008 and March 2009 to estimate the proportion of psychiatric medicines (antidepressants, antipsychotics and hypnotics/anxiolytics) reported at prison reception that are discontinued on entry to prison.ResultsOf the 1006 records sampled, the review showed that 18% of prisoners had been prescribed psychiatric medication before being placed in custody. Altogether, 240 separate psychiatric medicines were recorded among prisoners at reception. Of these, 47% were not prescribed during the first week of custody. In only 11% of cases where medication was discontinued had psychiatric assessment been completed.Clinical implicationsPrison mental health policy states that psychiatric medication should not be withdrawn in custody without proper clinical assessment. Denial of medication in the absence of clinical assessment during early custody has the potential to create additional stress in individuals during a period of increased vulnerability and risk.

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