netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 4: Central nervous system - Full Chapter
Notes:
In this section "SPECIALISTS" refer to medical prescribers specialising in Mental Health unless otherwise stated. At Guy's and St Thomas' and Lewisham Hospitals this would refer to SLAM employed consultants
 Details...
04.01  Expand sub section  Hypnotics and anxiolytics
04.01.01  Expand sub section  Hypnotics
Melatonin m/r tabs (sleep disorders in children - off-label)

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Restricted Drug Restricted
Amber 3
SPECIALIST INITIATION ONLY
Sleep disorders in children (off-label)

Link  SE London APC Shared Care Guidancance for Melatonin for the treatment of Sleep disorders in Children and Adolescents (age 1 - 17 years)    
Melatonin m/r tabs, liquid (adult sleep clinic use - off-label)

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Restricted Drug Restricted
Amber 3
SLEEP DISORDER CENTRE USE ONLY
  • REM sleep behaviour disorder (off-label)
  • Delayed sleep phase disorder (off-label)
  • Free running disorder (off-label)
    The liquid is restricted to use in swallowing difficulties, or in patients on a specific dose that is not practical to be given from the 2mg m/r tabs
  •    
    Venlafaxine m/r tabs (adult sleep clinic use - off-label)

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    Restricted Drug Restricted SLEEP DISORDER CENTRE USE ONLY
    Cataplexy (off-label)
       
    Melatonin tabs (Bio-melatonin brand) (adult sleep clinic use)

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    Restricted Drug Unlicensed
    Red
    SLEEP DISORDER CENTRE USE ONLY
  • Restricted to use in adult circadian rhythm disorders where a more sedative and immediate acting melatonin is required
  •    
    04.01.01  Expand sub section  Benzodiazepines
    Nitrazepam tabs, oral suspension

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    Formulary
       
    Controlled Drug  Temazepam tabs, oral solution

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    Formulary
       
    Loprazolam tabs

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    Formulary
       
    Clonazepam tabs

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    Restricted Drug Restricted
    Amber 2
    SLEEP DISORDER CENTRE USE ONLY
  • Parasomnias (off-label)
  • REM sleep behaviour disorder (off-label)
  •    
    04.01.01  Expand sub section  Zaleplon, Zolpidem and Zopiclone
    Zolpidem tabs (insomnia)

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    Formulary
       
    Zopiclone tabs (insomnia)

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    Formulary
       
    04.01.01  Expand sub section  Chloral and derivatives to top
    Chloral hydrate liquid

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    Restricted Drug Restricted INITIATION BY SPECIALIST ONLY
       
    04.01.01  Expand sub section  Clomethiazole (Chlormethiazole)
    Clomethiazole caps

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    Formulary
       
    04.01.01  Expand sub section  Sodium oxybate
    Controlled Drug  Sodium oxybate oral solution

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    Restricted Drug Restricted
    High Cost Medicine
    Amber 2
    RESTRICTED USE NAMED SPECIALIST CONSULTANTS AT GSTFT ONLY
    For disabling cataplexy in patients objectively diagnosed with narcolepsy and suffering from cataplexy of severity similar to the entry criteria for the positive US clinical trial.
       
    04.01.02  Expand sub section  Anxiolytics
    04.01.02  Expand sub section  Benzodiazepines
    Chlordiazepoxide caps, tabs

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    Formulary FIRST LINE FOR ACUTE ALCOHOL WITHDRAWAL
    Refer to local guidelines
       
    Diazepam tabs, oral solution, injection, rectal tubes

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    Formulary
       
    Lorazepam tabs, injection

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    Formulary
       
    04.01.02  Expand sub section  Buspirone to top
    Buspirone Hydrochloride tabs

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    Restricted Drug Restricted INITIATION BY SPECIALIST ONLY
       
    04.01.03  Expand sub section  Barbiturates
     ....
    Key
    note Notes First Choice Item First Choice item
    Section Title Section Title (top level) Non Formulary Item Non Formulary section
    Section Title Section Title (sub level)
    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    CD
    Controlled Drug
    Unlicensed Drug
    Unlicensed
    High Cost Medicine
    High Cost Medicine
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    Link to SPCs
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    Link to adult BNF
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Cancer Drugs Fund
    Cancer Drugs Fund
       

     

    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
      Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
      Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
      Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
      Green   Specialist and non-specialist initiation  
      Grey   Not recommended for prescribing  

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