BAP News

Unlicensed applications of licensed drugs in psychiatric practice: RCPsych and BAP work together to produce new guidance

Thursday, 7th December 2017

Updated: Thursday, 7th December 2017

Pharmacological treatment is an important component of much of psychiatric practice. Despite a wide range of psychotropic medications and psychological interventions, many patients remain troubled by distressing symptoms despite undergoing a series of pharmacological and psychological treatments. In this situation, doctors may wonder whether they might prescribe a medication outside the narrow terms of its market authorisation (‘product licence’) in an attempt to improve clinical outcomes. The Royal College of Psychiatrists first issued guidance on recommended procedures for the use of licensed medicines for unlicensed applications in psychiatric practice in 2007. In the subsequent decade, evidence on this aspect of practice has increased and other bodies including the General Medical Council have also provided guidance. The Psychopharmacology Committee was therefore asked to consider and if necessary revise current College guidance and did so working with representatives from the British Association for Psychopharmacology. We considered the potential benefits and risks of this aspect of clinical practice and believe that prescription of a drug outside the narrow terms of its market authorisation can be an appropriate part of overall management, and in the best interests of a patient. We strived to make ten balanced recommendations that are feasible to implement within current psychiatric practice.

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David Baldwin, Chair of the Psychopharmacology Committee