Less commonly prescribed psychotropic drugs in a psychiatric hospital.
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Biomedical subjects
Publications and source records attributed to B R Ballinger.
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Plasma phenytoin levels were measured in 60 patients under steady-state conditions for a period of six weeks. During the trial, the preparation of phenytoin was changed from Phenytoin BP (Regent) to Epanutin Infatabs. A significant increase in plasma phenytoin levels following the change of tablet was matched by a decrease in the number of seizures.
A survey of 351 accidents occurring in a two-year period in a psychiatric hospital showed that 77 per cent of the accidents involved female patients and 48 per cent involved patients with organic psychoses; 236 accidents were falls and 280 occurred in the ward setting. In 277 instances adequate controls were available. Seventy-five per cent of the accident patients had received a psychotropic drug on the day of the accident as opposed to 61 per cent of the controls. The possibility that the side-effects of psychotropic drugs may have contributed to some of these accidents is discussed.
Previous studies have shown varying rates of discrepancy in drug administration in psychiatric hospitals, and the present survey attempted to elucidate this problem further, using two methods of investigation simultaneously. Two wards in a psychiatric hospital and one ward in a mental subnormality hospital were studied. Urine specimens were tested for psychotropic drugs, and ward drug rounds were observed to detect discrepancies in administration. Of the 266 instances of drug administraion tested for in urine specimens, prescribed drugs were not detected in 7-9 per cent of cases and non-prescribed drugs were found in another 29 instances. Observation was made of 3,689 instances of drug administration, and in 1-7 per cent of these the drug was not given or taken as prescribed, whereas no instances of ingestion of non-prescribed drugs were observed. The reasons for the discrepancies and the different results obtained by the two methods are discussed.
This study attempted to assess the applicability of the Clinical Interview Schedule (Goldberg et al., 1970) to mentally handicapped patients in a hospital. Twenty-seven patients were rated simultaneously by three raters. Of the 31 items assessed for reliability, 11 were completely satisfactory, 8 were satisfactory, 6 unsatisfactory and 6 'not proven'. Ratings made by all raters for overall severity of psychiatric illness correlated significantly with similar ratings made by the consultants responsible for the patients.
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