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First-generation antipsychotics: not gone but forgotten.

Claire R M Dibben1, Golam M Khandaker2, Benjamin R Underwood3

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Psychiatry trainees lack confidence and training in prescribing first-generation antipsychotics (FGAs). This study highlights critical gaps, risking the loss of valuable FGA knowledge for future psychiatrists.

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Medical Education

Background:

  • First-generation antipsychotics (FGAs) remain relevant in psychiatric practice.
  • Understanding training needs and prescribing barriers for FGAs is crucial for next-generation psychiatrists.

Purpose of the Study:

  • To identify training needs of psychiatry trainees regarding FGAs.
  • To determine barriers to prescribing FGAs in current psychiatric practice.

Main Methods:

  • A survey was conducted among psychiatry trainees in East Anglia.
  • The survey assessed training experience, knowledge, and attitudes towards oral FGAs.

Main Results:

  • Two-thirds of trainees recognized similar efficacy between FGAs and second-generation antipsychotics (SGAs).
  • A significant proportion perceived FGAs as having more or stronger side-effects.
  • Lack of training experience was a major barrier, with a quarter receiving no FGA training and two-thirds never initiating them.
  • Confidence levels were significantly lower for initiating FGAs (40%) compared to SGAs (90%).

Conclusions:

  • Worrying gaps in psychiatric training concerning FGAs were identified.
  • Effective use of FGAs, minimizing side-effects through careful prescribing, is at risk of being lost.
  • Ensuring future psychiatrists are proficient in FGA prescribing is essential for comprehensive patient care.