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Prescriptions, licences and evidence

North Wales Department of Psychological Medicine, Hergest Unit, Bangor LL57 2PW;

David Nutt, Professor of Psychiatry

Department of Psychopharmacology, School of Medical Sciences, Bristol

^* Correspondence

Aims and method There is considerable confusion at present among clinicians as regards the appropriateness of prescribing off-licence. Because of the nature of the registration process it is likely that a considerable proportion of prescribing will always be off-licence. This paper seeks to clarify when it is appropriate to prescribe off-licence. We convened a workshop on behalf of the British Association for Psychopharmacology involving clinicians and regulators from a variety of countries to explore this issue both generally and for specific childhood and learning disability clinical situations. Recent statements from the defence unions and consumer groups were also scrutinised.

Results Across senior clinicians and regulators from a number of European countries and North America, there is a consensus that prescribing off-licence is a necessary part of the art of medicine.

Clinical implications Current advice to clinicians on the issue of off-licence prescribing can sometimes overemphasise the hazards and neglect the benefits that may stem from appropriate off-licence prescribing. Good prescribing involves specifying treatment goals and monitoring outcomes and it is more important to share this with the patient than it is to communicate the licensed status of the drug being prescribed.

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