Within GM promazine has historically been used as an “as required” alternative to benzodiazepines for agitation/acute disturbance but continued long-term outside the scope of its licensed indication.1 In some cases, it’s used alongside regular antipsychotic treatment, increasing the risk burden from polypharmacy and dual antipsychotic therapy.

Promazine is not endorsed in any recent national or regional guidelines for management of agitation and the BNF marks it as a drug considered to be “less suitable for prescribing”
Greater Manchester is a significant outlier for promazine prescribing.
Despite regional attention the prescribing figures for promazine had stayed relatively stable over the past 12 months prior to this cross-sector quality improvement initiative commencing.

Our Aim is to work collaboratively across the NHS Greater Manchester ICS to develop and implement a cohesive strategy to review and reduce inappropriate promazine prescribing and share our experience of how we came together as a system to address this.