In addition to the above, another problem at the National Mental Health Centre is drug overdose,315 both for the rapid tranquilization and sedation (for non-therapeutic purposes) of a patient upon admission to the facility and later, during the course of treatment.316 The monitoring revealed that in some cases, especially on weekends, in order to manage the patient's critical condition and achieve rapid tranquilization, doctors on duty, without proper prescription, use injectable forms of antipsychotic drugs so that the formally voluntary patient is not offered pills, which contradicts the national clinical practice recommendations (guidelines).317 In addition, the need for rapid tranquilization is not properly substantiated, the patient's condition is not monitored and the process is not documented in accordance with the above-mentioned recommendations (guidelines).318 As for the patient’s involvement in the process of psychiatric care, the monitoring results show that patients are not properly involved in this process, which is proved by the fact that some of the patients are not even aware of their diagnosis or the name of prescribed medicines, and do not have information about the alternative methods of treatment. The Special Preventive Group believes that under similar conditions, it is virtually impossible to form a positive therapeutic alliance between staff and patients and to significantly improve the patient's condition.319 Based on all the above, the Special Preventive Group concludes that the National Mental Health Centre and Batumi Medical Centre fail to adequately manage psychiatric cases. The services provided by these institutions are not oriented to recovery or based on respect for personal autonomy. Moreover, in some cases, the intervention carried out in these institutions causes significant harm to the patient. 315 The Special Preventive Group assumes that the use of maximum therapeutic dose of one antipsychotic drug in combination with average or even minimum therapeutic dose of another antipsychotic drug is an overdose. Such a combination of medications is dangerous and can be fatal. 316 Particular attention should be paid to the following combinations in terms of overdose: 1) In the same hourly regimen, parenterally, Haloperidol 30 mg three times (maximum therapeutic daily dose) and Zopin 300 mg three times (average therapeutic daily dose); 2) Psyzin (Trifluoperazine) 30 mg three times (maximum therapeutic daily dose) and Zopin (Clozapine) 200 mg (therapeutic dose); 3) Olan 10 mg twice (maximum dose) and Zopin 50 mg before going to bed (initial therapeutic dose). 317 National clinical practice recommendation (guideline) - Treatment and Management of Schizophrenia in Adults - Para. 4.8.2 (Treatment of an acute episode): "Offer oral antipsychotic medications during an acute episode or relapse of schizophrenia. Para. 4.8.2.2. (Rapid tranquilization): “Use rapid tranquilization after another strategy fails to calm the patient; Rapid tranquilization shall be an emergency treatment and not a primary therapeutic strategy." Para. 4.8.2.2.2. (Implementation of rapid tranquilization): "Offer oral medication if possible."Available at:< https://bit.ly/2XmJH2P > [last accessed 22.01.2020]. 318 Ibid, Para. 4.8.2.2.3 – Physical monitoring of rapid tranquilization. 319 The European Committee for the Prevention of Torture focuses on the vulnerability of formally voluntary patients and problems with patient’s involvement in the treatment process in the report on its visit to Georgia on 10-21 September 2018, p. 62-65, also p. 56-58. See the link:<https://rm.coe.int/1680945eca> [last accessed10.01.2020]. 107