Our results suggest that treatment with donepezil improves cognition and hallucinations without increasing parkinsonian symptoms, and its sudden withdrawal is usually detrimental, producing acute cognitive and behavioural decline. Although recommencement on donepezil appears to reverse this deterioration we do not advise its abrupt discontinuation in this population.

Background:  UK‐wide concerns about availability, cost, efficacy and inappropriate use of psychiatric inpatient provision for adolescents have led to the development of new models of intensive community based care. Method:  This paper describes the Fife Intensive Therapy Team (FITT) model and provides an analysis of HoNOSCA (Health of the Nation Outcomes Scale for Children and Adolescents) data for 57 patients to evaluate the effectiveness of the service. Results:  Following intervention by the FITT, a substantial and significant reduction in HoNOSCA scores was recorded. Conclusions:  The apparent success of the model has implications for the future development of acute mental health services for young people.

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