Cochrane Review Finds No Evidence for “PRN” Drugs in Mental Health Treatment

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It is common for “as required” or PRN (Pro re nata) medications to be prescribed during inpatient mental health visits. The most likely drugs prescribed “as needed” include benzodiazepines, antipsychotics, and sleeping pills. A newly updated Cochrane review finds, however, that “there is no good evidence” for this practice.

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Justin Karter
Justin Karter
Justin M. Karter, PhD, leads research news coverage and editorial strategy at Mad in America. He is the Acting Program Director of the PsyD in Clinical Psychology & Psychological Humanities at Boston College and part-time faculty with the Center for Psychological Humanities & Ethics. His scholarship examines historical and cultural formations of mind, subjectivity, and personhood; the roles of activist movements and lived-experience communities, including the consumer/survivor/ex-patient (C/S/X) tradition; and how mental health discourses shape institutions, practices, and identities. He works across mad studies, critical psychology, philosophy of psychology, and rights-based global mental health. Methodologically, he specializes in critical qualitative inquiry and psychotherapy process research grounded in intersubjective and phenomenological approaches. He is the President of APA Division 24 (2025-26) and serves on the Executive Board of Division 32. Previously, he was a Research Officer to the United Nations Special Rapporteur on the Right to Health. He earned his PhD in Counseling Psychology at the University of Massachusetts Boston, where his dissertation examined psychosocial disability advocacy in the global mental health movement. He also holds graduate degrees in Journalism and Community Psychology from Point Park University.
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5 COMMENTS

  3. Whats wrong with PRN ? This makes no sense to me.

    As needed is much better than steady state drugging.

    Anxiety and insomnia were my complaints and why would I want to do zombie anhedoinia pills all day instead of treating the problem as needed ?

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    • Because the alleged pros thought this came from some mysterious brain malfunction. Proper treatment would involve more examination directing a course of treatment without drugs. Alas, the PRN drugs for your difficulties are likely to be addictive.

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  4. “The most likely drugs prescribed “as needed” include benzodiazepines, antipsychotics, and sleeping pills.”

    As needed by who? The patient or the staff? Because I was surprised to find out that refusing to take a fist full of benzos and anti psychotics “as needed” constituted an “emergency” under the Mental Health Act (despite saying I would become ill as a result) and that you are then surrounded by a dozen staff and forcefully injected.

    I neither wanted or needed these drugs, and yet “no” means “yes”?

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