Pharmacists should be reviewing antipsychotic prescribing, psychiatrists have said, following concerns that too many schizophrenia patients are on multiple medicines.

Prescriptions for multiple medicines or high doses of antipsychotics needed to be reviewed by pharmacists to ensure they were justified, the Royal College of Psychiatrists (RCP) recommended, after an audit of NHS mental health trusts found 16 per cent of schizophrenia patients were on multiple medicines.

There was no good evidence to support this as a regular treatment strategy, the RCP said.

"Pharmacists do need to be reminded to check prescriptions for multiple medications, and for high doses" Jonathan Mason, NHS East London and the City	More on antipsychotics Antipsychotic prescriptions for dementia patients       halved since 2008 Welsh government urges pharmacists to tackle       prescribing dangers Antipsychotics death risk for dementia sufferers and       cancer patients
	The National Audit of Schizophrenia, published last week, revealed prescribing practice was very good in many PCTs. However, it also found that in some areas patients were not prescribed a trial of the antipsychotic clozapine despite the drug being widely used for patients resistant to other treatments.

Pharmacists needed to recognise these patients and ensure they were offered clozapine where necessary, the RCP recommended.

"Community pharmacists do need to be reminded to check prescriptions for multiple medications, and for high doses," said NHS East London and the City clinical advisor in medicines Jonathan Mason. "Prescribing of two antipsychotics may be necessary if one drug is being tapered down and a new drug initiated, but this should be for a short period."

Mr Mason said more needed to be done to strengthen the links between the two professions in the community and highlight the different roles of pharmacists to psychiatrists.

The report also suggested that mental health teams carried out regular audits with pharmacies and other healthcare professionals to ensure the guidelines for prescribing antipsychotics were understood and that appropriately trained clinical pharmacists were available to counsel patients about their medication.

The National Audit of Schizophrenia is one of three audits of the country's 64 mental health trusts carried out by a team of health professionals including psychiatrists and GPs.