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GPs 'not to blame for antipsychotic overprescribing'

By Lilian Anekwe

General practice has been unfairly ‘blamed' for the excess use of antipsychotics in patients with dementia, according to a GP researcher writing in the BMJ.

A Department of Health-funded report, published last month, found inappropriate prescribing of antipsychotics is responsible for 1,800 deaths a year, with many prescribed by GPs who were using them ‘too often' to manage patients with dementia.

But an audit of prescribing of antipsychotics at one practice in June 2009 found that the overwhelming majority of patients taking antipsychotics had been prescribed them by specialists who kept patients on the drugs for far too long.

Over 90% of patients with dementia who were taking antipsychotics were initiated on the drugs in secondary care by the local elderly care psychiatry team, and not by their GP.

Most remained under secondary care follow-up, and the majority had been taking antipsychotics for over a year – well beyond the six weeks currently recommended.

In his letter to the BMJ, published last week, Dr Thomas Groves, a GP in Studley, Warwickshire, said GPs were aware of the risks of antipsychotics but were left with few options as nursing homes are ‘stretched to the limit'.

And he urged the DH not to waste money on the GP training that was promised in its report and direct the money to tackling secondary care prescribing instead.

‘Please don't waste more money and resources teaching hard working general practitioners how to look after patients with dementia,' he said. 'Please tackle the problem and use resources where they have the biggest impact.'

Many antipsychotics are initiated in secondary care

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