2007; Tishler and Reiss, 2011]. Furthermore while clinicians continue to prescribe medicines in novel and off-licence situations during routine practice, this represents an opportunity to collect efficacy and safety data [Baldwin and Kosky, 2007]; it is vital these applications are recorded and reported. Others authors [Tishler and Reiss, 2011] have recommended the systematic Inhibitors,research,lifescience,medical collection of data on adverse effects. Studying how uncorroborated off-label use disseminates into treatment practice may help judge the standards of existing regulatory policies, and would contribute to a credible body of data to guide prescribers in common situations and the pharmaceutical

industry on which drugs and when are Inhibitors,research,lifescience,medical strong candidates for further investigation. These proposals challenge clinicians to remain informed of the evidence base as it develops [Stafford, 2008]. As healthcare makes the transition to electronic health records, increasingly precise documentation of diagnosis, prescribing and outcomes is likely to be achievable Inhibitors,research,lifescience,medical [Walton

et al. 2008]. Other solutions include carefully accumulating and analysing post marketing information and focusing on efficacy and safety data beyond the official licence, in the style of Cochrane reviews and the Maudsley Prescribing Guidelines [Stafford, 2008]. There is also a clear need for more resources to be devoted to making the evidence base as accessible as possible for practitioners, such as the development of a concise yet comprehensive guide which will be frequently updated and can cite the level of evidence supporting common off-label use [Walton et al. 2008]. This goes beyond what current classification frameworks are able to offer to date. A funded national specialist mental Inhibitors,research,lifescience,medical health centre, dedicated to off-label prescribing and research, would provide a recognized source of information for practitioners and lead to major improvements in appropriate psychotropic prescribing. It could also be the base for systematic reviews to gather and buy 5-FU evaluate

previous RCT support for psychotropics and recognize where Inhibitors,research,lifescience,medical the Phosphoprotein phosphatase largest information gaps exist. Recommendations Society, through its governing institutions, has a duty to balance the expectations of the various stakeholders involved in providing evidence-based healthcare. These include the regulatory authorities, ethics committees, prescribers, pharmaceutical companies, academia, public and private healthcare providers and most importantly the people who receive treatment. As we have shown for psychotropics, the current system offers a superficially clear, but highly restrictive, licensing system, while tacitly accepting that clinical flexibility is needed in the real world. It does so by placing responsibility and accountability firmly in the hands of the individual prescriber that, faced with the needs of their patient, are permitted to prescribe off-licence.