title: Conventional antipsychotic prescription in unipolar depression, I: an audit and recommendations for practice.
abstract: BACKGROUND
  Despite narrow indications for conventional antipsychotics in depression, recent reports confirm a suspicion that they are widely prescribed in nonpsychotic depressive conditions.
  
  
  METHODS
  Data from the case notes of over 510 patients with unipolar depression (unvalidated clinical diagnoses) were collected between June 1997 and January 1998 from community and acute units in 1 National Health Service (NHS) Trust. The aim of this audit was to assess the extent and pattern of antipsychotic prescription in this sample.
  
  
  RESULTS
  More than a quarter (N = 138) of the sample (N = 494) were currently prescribed an antipsychotic; 40% of these received an antipsychotic without any recognized indication. The mean time on antipsychotic therapy was 3 years. Patients on antipsychotic therapy were, on average, taking twice as many total medications as those not on antipsychotic therapy. Patients with psychotic depression were taking an average of nearly twice the antipsychotic dose of nonpsychotic patients.
  
  
  CONCLUSIONS
  Current clinical guidelines commend careful antidepressant choice in preference to polypharmacy. A number of drug choices for specific depressive presentations are summarized from recent sources.
authors.affiliation: Department of Psychology, New School for Social Research, New York, NY, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Wheeler Vega
authors.forename: Ann M
authors.initials: AM
authors.lastname: Mortimer
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Tyson
mesh_terms: D000293:Adolescent; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000188:drug therapy; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D017723:Drug Utilization Review; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D013222:State Medicine / Q000706:statistics & numerical data; D006113:United Kingdom
chemical_list: D014150:Antipsychotic Agents