Obstacles in implementation of higher unit dosage of psychotropics drugs.

Practitioners, nurses, pharmacists and patients themselves must be considered in a discussion of higher unit dosage of psychotropic medication. Physicians need postgraduate education to overcome their reluctance to prescribe higher unit dosages. Nurses need in-service training regarding principles in clinical pharmacology to comply with changing prescribing practices. Higher unit dosage leads to less medication error and frees considerable nursing time. Pharmacists face a problem in inventory costs, therefore are reluctant to stock a variety of dosages. Patients taking multiple medications in high dosages hesitate to take large numbers of low dosage pills, thus patient compliance is enhanced with higher unit dosage. Blood level data on formulations of higher unit dosage should be the basis of FDA considerations, rather than treating a higher unit dosage as a new drug. The final responsibility in providing higher unit dosage rests with the pharmaceutical companies. However, the introduction of higher unit dosage should not be used as a justification to increase cost per milligram of the same medication. Utilization of a different salt to introduce a higher unit dosage should be done only if there is substantial difference between the new salt and the one already available.