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 Formulary Chapter 4: Central nervous system - Full Chapter
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04.02.01  Expand sub section  Antipsychotic Drugs
04.02.01  Expand sub section  First-Generation Antipsychotic Drugs
04.02.01  Expand sub section  Second-Generation Antipsychotic Drugs
Amisulpride
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Restricted Drug Restricted  
   
Aripiprazole (Abilify)
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Restricted Drug Restricted
Green
Tablet
Dispersible tablets
Liquid
Injection (IM use)
Injection (prolonged release suspension for injection)
 
Link  NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years (NICE TA 213)
Link  NICE TA292: Bipolar disorder (children) - aripiprazole (NICE TA292)
   
Clozapine (Clozaril)
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Restricted Drug Restricted
Red
HOSPITAL ONLY
  • To be initiated by consultant psychiatrist only. For treatment-resistant schizophrenia

    Tablets 25mg and 100mg
  • Usual dose range: Adjustable initial titration (CPMS blood tests) 200-450mg
  • Max daily dose: Max 900mg
     
  • Link  clozapine - management of admissions to BRI wards
       
    Clozapine (Denzapine)
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    Restricted Drug Restricted CLOZARIL brand used within BTHFT 
       
    Clozapine (Zaponex)
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    Restricted Drug Restricted CLOZARIL brand used within BTHFT 
       
    Olanzapine (Zyprexa)
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    Restricted Drug Restricted
    Green
    Tablets 2.5mg, 5mg, 10mg, 15mg, 20mg ; dispersible tablets also available (significantly more expensive)
  • second generation antipsychotic
  • Usual dose range 5-20mg daily
  • Max daily dose 20mg
  • Max single dose 20mg 
  •    
    Quetiapine (Seroquel)
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    Formulary
    Green
    Tablets 50mg, 100mg, 150mg, 300mg, 400mg. Modified release (XL) tablets also available, but siginificantly more expensive
    Second generation anitpsychotic
  • Usual dose range 300mg-600mg
  • max daily dose 800mg plain tablets or 800mg XL

     
  •    
    Risperidone (Risperdal)
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    Formulary
    Green
    Tablets,500 micrograms,1 mg, 2 mg, 3 mg, 4 mg, 6 mg
    Orodispersible tablets also available
    Liquid 1 mg/mL
    Note Liquid may be diluted with any non-alcoholic drink, except tea
  • Second generation antipsychotic
  • Initially 2mg daily Usual dose range 4-6mg daily
  • Max daily dose 16mg, no benefit generally seen above 10mg daily
     
  •    
     ....
     Non Formulary Items
    Lurasidone  (Latuda®)

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    Non Formulary
     
    Paliperidone

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    Non Formulary
    Amber
     
    Sertindole  (Serdolect)

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    Non Formulary
     
    Ziprasidone  (Zeldox)

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    Non Formulary
     
    Zotepine  (Zoleptil®)

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    Non Formulary
     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Amber

    Medicines suitable to be prescribed in primary care after Specialist* recommendation or initiation. A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust D&TC(s). *Specialist is defined as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice.   

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (D&TC) * All drugs awaiting the production or approval of a shared care guideline default to RED   

    Cancer Drug Fund

    Cancer Drug Fund   

    Green

    Medicines suitable for routine use and can be prescribed within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.  

    Green Specialist Initiation

    These drugs should be initiated only by a hospital or specialist clinician (GPSi) but there is no requirement for additional monitoring over the general requirements for all medicines. Some may require short or medium specialist monitoring of efficacy or dose titration before transferring in Primary care. The GP should have all the information they require to support continued prescribing.   

    Green Specialist Recomendation

      

    Grey

    Grey - Medicines, which the Drug & therapeutics Committee has actively reviewed and does not recommend for use at present following a review of clinical and/or cost effective data. Grey (assessment in progress) - will be reviewed at a future D&T meeting. Grey (awaiting submission) - The D&T are awaiting a submission from an appropriate practitioner. If you wish to make a submission for this medicine to be added to the formulary please email drug.information@bthft.nhs.uk .   

    Non Formulary

    Not recommended for prescribing as initial therapy, but can be continued if patient already stable on treatment   

    Red

    Medicines which should normally be prescribed by specialists only. ** For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care   

    RED ULM

    Unlicensed Medication  

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