North Staffordshire Joint Formulary Formulary


	North Staffordshire Joint Formulary North Staffordshire Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group

Search

Formulary Chapter 4: Central nervous system - Full Chapter

04.02.01

Antipsychotic Drugs

NICE CG103: Delirium: prevention, diagnosis and management

NICE CG178: Psychosis and schizophrenia in adults: prevention and management

04.02.01

First-Generation Antipsychotic Drugs

04.02.01

Second-Generation Antipsychotic Drugs

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

Formulary

Amisulpride Tablet 50mg
Amisulpride Tablet 100mg
Amisulpride Tablet 200mg
Amisulpride Tablet 400mg
Amisulpride Oral Solution 100mg/ml SF

Aripiprazole

Formulary

FIRST CHOICE
Aripiprazole Tablet 5mg
Aripiprazole Tablet 10mg
Aripiprazole Tablet 15mg
Aripiprazole Tablet 30mg

SECOND CHOICE
Aripiprazole Orodispersible Tablet 10mg S/F
Aripiprazole Orodispersible Tablet 15mg S/F

THIRD CHOICE
Aripiprazole Oral Solution 5mg/5ml- Use liquid only in patients with swallowing difficulties due to higher costs (Applicable in Primary care only)

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

Clozapine (Clozaril^®)
(Prescribe by brand)

Formulary

Clozapine Tablet 25mg
Clozapine Tablet 50mg
Clozapine Tablet 100mg
Clozapine Tablet 200mg

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)

Olanzapine

Formulary

Olanzapine Tablet 2.5mg
Olanzapine Tablet 5mg
Olanzapine Tablet 7.5mg
Olanzapine Tablet 10mg
Olanzapine Tablet 15mg
Olanzapine Tablet 20mg
Olanzapine Orodispersible Tablet 5mg
Olanzapine Orodispersible Tablet 10mg
Olanzapine Orodispersible Tablet 15mg

Do not prescribe Oral Lyophilisates preparations - Very Expensive-(Applicable in Primary care only)

Quetiapine

Formulary

FIRST CHOICE- normal release tablets
Quetiapine Tablet 25mg
Quetiapine Tablet 100mg
Quetiapine Tablet 150mg
Quetiapine Tablet 200mg
Quetiapine Tablet 300mg

SECOND CHOICE - MR where there are compliance issues
Sondate XL Tablet 50mg
Sondate XL tablet 150mg
Sondate XL Tablet 200mg
Sondate XL Tablet 300mg
Sondate XL Tablet 400mg

THIRD CHOICE - If Sondate XL is unavailable
Biquelle XL Tablet 50mg
Biquelle XL tablet 150mg
Biquelle XL Tablet 200mg
Biquelle XL Tablet 300mg
Biquelle XL Tablet 400mg

Prescribers should choose the most cost-effective option (Applicable in Primary care only)

Risperidone

Formulary

Risperidone Tablet 500mcg
Risperidone Tablet 1mg
Risperidone Tablet 2mg
Risperidone Tablet 3mg
Risperidone Tablet 4mg
Risperidone Orodispersible Tablet 500mcg SF
Risperidone Orodispersible Tablet 1mg SF
Risperidone Orodispersible Tablet 2mg SF
Risperidone Orodispersible Tablet 3mg SF
Risperidone Orodispersible Tablet 4mg SF
Risperidone Oral Solution 1mg/ml SF

Prescribe generically

See APC advice above (March 2010)

Levomepromazine (Methotrimipramine)

Formulary

Levomepromazine Tablets 25mg
Levomepromazine solution for injection ampoules 25mg/ml

Restriction: For use in Palliative Care

....

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG
	High Cost Drug Approval System

Traffic Light Status Information

Status	Description
	Medicines that can only be prescribed within Secondary Care. Examples of medicines which fall into this category are: Certain new medicines and new indications for older medicines where there is at present no experience of use in Primary Care. Medicines or dressings not available or prescribable in Primary Care. Where a medicine has been classified as Amber E, but an approved shared-care guideline is not yet available
	Medicines which can be prescribed within Secondary Care, but are only suitable for prescribing in Primary Care after specialist referral. There is no need for approved shared care guidelines for medicines in this category. This replaces Amber 2 on the North Staffs Formulary.
	Medicines which can be prescribed within Secondary Care, but are only considered suitable for prescribing in Primary Care under an approved shared-care agreement (ESCA) or Rationale for Initiation, Continuation and Discontinuation (RICaD). This replaces Amber 1 on the North Staffs Formulary
	Medicines which can be prescribed in either Primary or Secondary Care.
	These medicines have been reviewed by the New Medicines Committee and the Area Prescribing Committee and found not to be suitable for inclusion in the Joint Formulary. Inadequate or weak evidence for efficacy No clearly defined local need Lack of long term safety data No perceived benefit over established formulary alternatives Prescribers can consider these medicines where formulary alternatives are unsuitable, ineffective or not tolerated.