that the patient is receiving high dose antipsychotics and set up an alert on the patient's RiO record for the duration the high dose prescription is in place. ii. Complete a High Dose Antipsychotic Prescribing Monitoring Form (Appendix 1) for the patient and attach to the current medicines card. Once the Form is completed or the

Selecting an antipsychotic 11 3. Guidelines for first episode psychosis 13 4. High dose antipsychotic medication 16 5. Drug interactions 19 6. Cardiac Risk including QT prolongation 21 7. Regulation of prolactin secretion 24 8. Use of antipsychotics in pregnancy 28 9. Use of antipsychotics when breast-feeding 30 10. Evidence-Based Recommendations for Monitoring Safety of Second Generation Antipsychotics in Children and Youth. Evidence-based recommendations for monitoring SGA safety are provided in the guideline. Kester H, Dethomas C, Kafantaris V, Kane J. Clozapine and "high-dose" olanzapine in A6 High Dose Antipsychotic Treatment (HDAT) summary sheet 19 Key EPSE Extrapyramidal side effects BPSD Behavioural and psychological symptoms of dementia FGA First generation antipsychotic (typical) SGA Second generation antipsychotic (atypical) TDM Therapeutic dose monitoring LAI Long acting injection ECT Electro Convulsive Therapy Guidelines for the use of High Dose Antipsychotics Introduction A high dose of antipsychotic is defined as a total daily dose (whether of a single antipsychotic or more than one prescribed combination) greater than 100% of the maximum recommended daily dose (Royal College of Psychiatrists, 2006). Antipsychotic Monitoring PLEASE NOTE THIS IS NOT A SHARED CARE GUIDELINE, NOR IS IT A FULL SUMMARY OF DRUG INFORMATION. ALWAYS REFER TO THE MOST RECENT BNF AND/OR SUMMARY OF PRODUCT CHARACTERISTICS. Dose and frequency of medication Guideline: High-dose antipsychotic prescribing Review date: 30/03/2018 Page 2 of 16 an inevitable part of routine practice. The purpose of this guidance is to ensure robust procedures fo