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Attitudes to antipsychotics: a multi-site survey of Canadian psychiatry residents

Anees Bahji (Department of Psychiatry, Queen’s University, Kingston, Canada)
Neeraj Bajaj (Department of Psychiatry, Queen’s University, Kingston, Canada)

The Journal of Mental Health Training, Education and Practice

ISSN: 1755-6228

Article publication date: 13 November 2018

Issue publication date: 14 November 2018




The purpose of this paper is to identify the training needs of the next generation of psychiatrists, and barriers in prescribing first-generation antipsychotics (FGAs), long-acting injectable (LAIs) antipsychotics and clozapine.


An electronic survey was sent to psychiatry residents (N= 75/288, 26 percent) at four Canadian residency programs in late December 2017. The survey was based on an instrument originally developed at the University of Cambridge and consisted of 31 questions in 10 content domains.


Nearly 80 percent of residents were aware that FGAs and second-generation antipsychotics (SGAs) have similar efficacy. However, extra-pyramidal symptoms and lack of training experience were the leading concerns associated with the prescribing of FGAs. Although over 90 percent of residents felt confident about initiating an oral SGA as a regular medication, only 40 percent did so with FGAs. Confidence with initiating LAIs and clozapine was 60 and 61 percent, respectively.

Practical implications

The survey highlights the need for better training in the use of FGAs, clozapine and LAIs. These medications can be effectively used in providing patients with the most appropriate evidence-based treatment options to improve treatment outcomes, while ensuring that these resources are not lost to the future generations of psychiatrists.


The survey may be the first of its kind to assess antipsychotic prescribing attitudes in Canadian psychiatry residents in multiple sites.



The authors have no potential conflicts of interest and no financial support to disclose. In summary, Dr Anees Bahji and Dr Neeraj Bajaj both report no competing interests. There are no further acknowledgments at this time.


Bahji, A. and Bajaj, N. (2018), "Attitudes to antipsychotics: a multi-site survey of Canadian psychiatry residents", The Journal of Mental Health Training, Education and Practice, Vol. 13 No. 6, pp. 318-338.



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