North Staffordshire Clinical Commissioning Group
Stoke-on-Trent Clinical Commissioning Group
APC advice (March 2010)
The balance of risks and benefit should be considered before prescribing antipsychotics drugs for elderly patients. In elderly patients with dementia antipsychotic drugs are associated with a small increased risk of mortality and an increased risk of stroke or transient ischaemic attack.
- Risperidone is licensed for short-term treatment (up to 6 weeks) of persistent aggression in patients with moderate to severe Alzheimer’s dementia unresponsive to non-pharmacological interventions and when there is a risk of harm to self or others. Therefore it is recommended as 1st line therapy in these circumstances
| Amisulpride |
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Formulary
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Amisulpride Tablet 50mg |
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| Aripiprazole |
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Formulary
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FIRST CHOICE SECOND CHOICE THIRD CHOICE Prescribe generically. |
 NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years NICE TA292: Aripiprazole for treating moderate to severe manic episodes in adolescents with bipolar I disorder |
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| Clozapine Clozaril® |
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Formulary
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Clozapine Tablet 25mg Restriction: Initiation by psychiatrist registered with Clozapine monitoring service Patient, prescriber and supplying pharmacist must be registered with the Patient Monitoring Service. Treatment is only continued if there are acceptable leucocyte and neutrophil counts. Brands include Clozaril, Denzapine or Zaponex. MHRA/CHM advice: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus (October 2017) |
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| Levomepromazine Methotrimipramine |
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Formulary
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Levomepromazine Tablets 25mg
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Links
- NICE CG103: Delirium: prevention, diagnosis and management
- NICE CG178: Psychosis and schizophrenia in adults: prevention and management
- NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years
- NICE TA292: Aripiprazole for treating moderate to severe manic episodes in adolescents with bipolar I disorder