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The number of prescriptions by GPs for anti-psychotic drugs is on the increase and is set to top 2.7 million by the end of the year, GP can reveal.

Figures obtained from the NHS Prescription Pricing Division under a Freedom of Information Act request show that the prescribing of olanzapine and risperidone by GPs in England is set to rise for the second year running despite safety concerns.

In March 2004, the MHRA advised against using the drugs to treat dementia after they were found to raise the risk of stroke.

But the figures show that in 2006 GPs signed off 1,438,431 prescriptions for olanzapine and 1,042,385 for risperidone.

The following year, the number of prescriptions increased to 1,533,494 for olanzapine and 1,099,514 for risperidone.

The figures for 2008 are currently only available up to May. But extrapolating the results for the whole of 2008 suggests that prescriptions for the drugs will increase for a second year running.

By the end of 2008, it is estimated that GPs will issue 1,591,224 prescriptions for olanzapine and 1,129,070 for risperidone, a total of 2,720,294 prescriptions for the drugs. This is a 9.6 per cent rise for both drugs over two years.

This summer health minister Ivan Lewis pledged a 'zero tolerance' crackdown on the use of the drugs for dementia patients.

GP revealed that charities were calling for doctors to face sanctions (GP, 27 June) and that GPs could be struck off for prescribing anti-psychotics to dementia patients (GP, 11 July).

Irwin Nazareth, professor of primary care and population sciences at University College London and an expert in schizophrenia, said that the level of prescribing was unlikely to be related to an increase in schizophrenia, for which the drugs can be prescribed.

He said: 'It may be related to the pressures of dealing with dementia and the slow increase in numbers of people with dementia in primary care.

'Another factor could be the lack of guidance offered to primary care professionals on alternatives to managing agitation and aggression in people with dementia.

'There has been no guidance provided to primary care on the management of people with dementia who have been stabilised on risperidone or olanzapine for some time,' he added.

sanjay.tanday@haymarket.com

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