83 Evaluation of clarity of the STOPP/START criteria - SI Table SI1.1. Continued. STOPP Action Clarity rating Condition Clarity rating Explanation Clarity rating D2 Initiation of Tricyclic Antidepressants (TCAs) 67% as first-line antidepressant treatment 33% (higher risk of adverse drug reactions with TCAs than with SSRIs or SNRIs). 42% D3 Neuroleptics with moderatemarked antimuscarinic/ anticholinergic effects (chlorpromazine, clozapine, flupenthixol, fluphenzine, pipothiazine, promazine, zuclopenthixol) 33% with a history of prostatism or previous urinary retention 75% (high risk of urinary retention). 92% D4 Selective serotonin re-uptake inhibitors (SSRI’s) 67% with current or recent significant hyponatraemia i.e. serum Na+ < 130 mmol/l 75% (risk of exacerbating or precipitating hyponatraemia). 92% D5 Benzodiazepines 67% for ≥ 4 weeks 33% (no indication for longer treatment; risk of prolonged sedation, confusion, impaired balance, falls, road traffic accidents; all benzodiazepines should be withdrawn gradually if taken for > 2 weeks as there is a risk of causing a benzodiazepine withdrawal syndrome if stopped abruptly). 100% D6 Antipsychotics (i.e. other than quetiapine or clozapine) 75% in those with parkinsonism or Lewy Body Disease 100% (risk of severe extra-pyramidal symptoms) 83% 2
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