‘Safety First: Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness’ recommends that patients at risk of suicide, including all patients with a recent history of self-harm, who are treated with psychotropic drugs should receive modern, less toxic drugs and/or supplies lasting no more than 2 weeks.

Propranolol Toxicity in Overdose in Children (January 2025)

Update for Primary Care Topiramate New Pregnancy Prevention Programme V1

Valproate: Review by two specialists is required for initiating valproate under 55 years of age, but not for male patients already taking valproate (Drug safety update Feb 2025)

Valproate: New safety and educational materials to support regulatory measures in men and women under 55 years of age (Drug safety update January 2024)

1. It is important that analgesics are given regularly for chronic pain as they are more effective in preventing than relieving pain. Adequate doses of non-opioids given regularly will often make the use of opioids unnecessary.

2. Analgesics have a 'dose ceiling' with regard to efficacy, and the variable side-effect profile up to the maximum useful dose will influence the choice of a particular analgesic.

For advice on pain relief in palliative care see BNF Prescribing in Palliative Care, Joint Formulary Palliative Care Guidelines (chapter 16) and contact the medical staff at:

Mount Edgcumbe Hospice - 01726 65711

St Julia's Hospice - 01736 759070

St Luke's Hospice - 01752 401172

Guidance on other supportive treatments may be obtained from the Pain Relief Clinic at Royal Cornwall Hospital Trust - 01872 252792