Welcome to the official Maudsley Prescribing Guidelines website


15th Edition of the Maudsley Prescribing Guidelines in Psychiatry is planned for May 2024.

The 14th Edition of the Guidelines (2021) is available in paperback and ebook. 

Professor David Taylor continues as lead author and editor, joined by co-authors Professor Thomas Barnes (Imperial College, London) and Professor Allan Young (King’s College, London).

More information can be found on our Order page.

The 4th Maudsley Prescribing Guidelines International Conference “Clinical Psychopharmacology in the time of COVID” was held remotely on Wednesday 20th October 2021.

List of chapter of the Guidelines 14th edition:

Part 1 Drug Treatment of major psychiatric conditions

Chapter 1 Schizophrenia and related psychoses

General introduction
Antipsychotics – general principles of prescribing
Antipsychotics – minimum effective doses
Antipsychotics – quick reference for licensed maximum doses
Antipsychotics – equivalent doses
High-dose antipsychotics: prescribing and monitoring
Combined antipsychotics (antipsychotic polypharmacy)
Antipsychotic prophylaxis
Negative symptoms
Relative adverse effects – a rough guide
Treatment algorithms for schizophrenia
First-generation antipsychotics – place in therapy
NICE guidelines for the treatment of schizophrenia
Antipsychotic response – to increase the dose, to switch, to add or just wait – what is the right move?
Acutely disturbed or violent behaviour
Antipsychotic depots/long-acting injections (LAIs)
Depot/LAI antipsychotics – pharmacokinetics
Management of patients on long-term depots/LAIs
Aripiprazole long-acting injection
Olanzapine long-acting injection
Paliperidone palmitate long-acting injection
Risperidone long-acting injection
Risperidone subcutaneous long-acting injection

Newer long-acting injectable antipsychotic preparations
Penfluridol weekly
Electroconvulsive therapy and psychosis
Omega-3 fatty acid (fish oils) in schizophrenia
Stopping antipsychotics
Extrapyramidal symptoms
Treatment of tardive dyskinesia
Antipsychotic-induced weight gain
Treatment of antipsychotic-induced weight gain
Neuroleptic malignant syndrome
ECG changes – QT prolongation
Effect of antipsychotic medications on plasma lipids
Diabetes and impaired glucose tolerance
Blood pressure changes with antipsychotics
Hyponatraemia in psychosis
Sexual dysfunction
Switching antipsychotics
Venous thromboembolism
Clozapine initiation schedule
Intramuscular clozapine
Optimising clozapine treatment
Alternatives to clozapine
Re-starting clozapine after a break in treatment
Guidelines for the initiation of clozapine for patients based in the community


Clozapine: common adverse effects
Clozapine: uncommon or unusual adverse effects
Clozapine: serious haematological and cardiovascular adverse effects
Clozapine-induced hypersalivation
Clozapine-induced gastrointestinal hypomotility (CIGH)
Clozapine, neutropenia and lithium
Clozapine and chemotherapy
Clozapine-genetic testing for clozapine treatment

CHAPTER 2 Bipolar disorder

Antipsychotics in bipolar disorder
Antipsychotic long-acting injections in bipolar disorder
Physical monitoring for people with bipolar disorder
Treatment of acute mania or hypomania
Rapid cycling bipolar affective disorder

Bipolar depression
Prophylaxis in bipolar disorder
Stopping lithium and mood stabilisers

Chapter 3 Depression and anxiety disorders

Introduction to Depression
Official guidance on the treatment of depression
Antidepressants – general overview
Recognised minimum effective doses of antidepressants
Drug treatment of depression
Management of treatment-resistant depression – first choice
Management of treatment-resistant depression – second choice
Treatment-resistant depression – other reported treatments
Psychotic depression
Switching antidepressants
Antidepressant withdrawal symptoms
Stopping antidepressants 348
Electroconvulsive therapy (ECT) and psychotropic drugs
Psychostimulants in depression
Post-stroke depression
Antidepressants – alternative routes of administration
Antidepressant prophylaxis
Drug interactions with antidepressants
Cardiac effects of antidepressants – summary
Antidepressant-induced arrhythmia
Antidepressant-induced hyponatraemia
Antidepressants and hyperprolactinaemia
Antidepressants and diabetes mellitus
Antidepressants and sexual dysfunction
SSRIs and bleeding
St. John’s Wort
Antidepressants: relative adverse effects – a rough guide
Anxiety spectrum disorders
Benzodiazepines in the treatment of psychiatric disorders
Benzodiazepines, z-drugs and gabapentinoids: dependence, detoxification and discontinuation
Benzodiazepines and disinhibition

Chapter 4 Addictions and substance misuse

Alcohol dependence
Alcohol withdrawal delirium – delirium tremens
Opioid dependence
Nicotine and smoking cessation
Pharmacological treatment of dependence on stimulants
GHB and GBL dependence
Benzodiazepine misuse
Synthetic cannabinoid receptor agonists (SCRAs)

Drug-induced excited state
Interactions between ‘street drugs’ and prescribed psychotropic drugs
Drugs of misuse – a summary
Substance misuse in pregnancy

Part 2 Drug treatment of special patient groups

Chapter 5 Children and adolescents

Principles of prescribing practice in childhood and adolescence
Depression in children and adolescents
Bipolar illness in children and adolescents
Psychosis in children and adolescents
Anxiety disorders in children and adolescents
Obsessive compulsive disorder (OCD) and body dysmorphic disorder (BDD) in children and adolescents
Post-traumatic stress disorder in children and adolescents
Attention deficit hyperactivity disorder
Autism Spectrum Disorder
Tics and Tourette syndrome
Melatonin in the treatment of insomnia in children and adolescents
Rapid tranquillisation (RT) in children and adolescents
Doses of commonly used psychotropic drugs in children and adolescents

Chapter 6 Prescribing in older people 
General principles
Safer prescribing for physical conditions in dementia
Management of behavioural and psychological symptoms of dementia (BPSD)
A guide to medication doses of commonly used psychotropics in older adults

Covert administration of medicines within food and drink
Treatment of depression in older people

Chapter 7 Pregnancy and breastfeeding 
Drug choice in pregnancy

Chapter 8 Hepatic and renal impairment 
Hepatic impairment
Renal impairment

Part 3 Prescribing in specialist conditions

Chapter 9 Drug treatment of other psychiatric conditions 
Borderline personality disorder (BPD)
Eating disorders

Chapter 10 Drug treatment of psychiatric symptoms occurring in the context of other disorders 
General principles of prescribing in HIV
22q11.2 deletion syndrome
Learning disabilities
Huntington’s disease – pharmacological treatment
Multiple sclerosis
Parkinson’s disease
Atrial fibrillation – using psychotropics
Recommendations – psychotropics in AF
Psychotropics in bariatric surgery
Prescribing in patients with psychiatric illness at the end of life
Part 4 Other aspects of psychotropic drug use

Chapter 11 Pharmacokinetics 
Plasma level monitoring of psychotropic drugs
Interpreting postmortem blood concentrations
Acting on clozapine plasma concentration results
Psychotropics and cytochrome (CYP) function
Smoking and psychotropic drugs
Drug interactions with alcohol

Chapter 12 Other substances


Chapter 13 Psychotropic drugs in special conditions 
Psychotropics in overdose
Driving and psychotropic medicines
Psychotropics and surgery

Chapter 14 Miscellany 
Enhancing medication adherence
Re-starting psychotropic medications after a period of non-compliance
Biochemical and haematological effects of psychotropics
Summary of psychiatric side effects of non-psychotropics
Prescribing drugs outside their licensed indications (‘off-label’ prescribing or unapproved use of approved drugs)
Examples of acceptable use of drugs outside their product licences/labels
The Mental Health Act in England and Wales
Site of administration of intramuscular injections
Intravenous formulations in psychiatry