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:

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

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...
04.02.01  Expand sub section  Antipsychotic Drugs
Chlorpromazine tabs, syrup
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Formulary
Amber 2
 
   
Haloperidol caps, tabs, oral liquid, injection
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Formulary
Amber 2
 
   
Levomepromazine tabs, injection
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
   
Loxapine  (Adusave 9.1 mg inhalation powder)
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Restricted Drug Restricted
Red

USE IS RESTRICTED TO THE SLAM AND OXLEAS TRUSTS ONLY

For rapid control of mild-moderate agitation in schizophrenia or bipolar disorder in adults 

 
   
Pimozide tabs
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Formulary
Red
 
   
Prochlorperazine tabs, injection
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Formulary  
   
Promazine hydrochloride tabs
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Formulary  
   
Sulpiride tabs, oral solution
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
   
Trifluoperazine tabs, caps, oral solution
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
   
Zuclopenthixol acetate injection
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Restricted Drug Restricted
Red
INITIATION BY SPECIALIST ONLY 
   
Zuclopenthixol dihydrochloride tablets
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
   
Haloperidol injection
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Restricted Drug Restricted
Red

Approved off-label indication:
Sedation in the ICU

Restricted to use in accordance with a local critical care guideline

 
   
04.02.01  Expand sub section  Second-Generation Antipsychotic Drugs
Amisulpride tabs, solution
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
   
Aripiprazole tabs
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
Link  NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years
Link  NICE TA292: Aripiprazole for treating moderate to severe manic episodes in adolescents with bipolar I disorder
   
Clozapine tabs
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Restricted Drug Restricted
Red
INITIATION BY SPECIALIST ONLY 
Link  MHRA Oct 17: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus
   
Lurasidone tabs
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Restricted Drug Restricted
Red

INITIATION BY SPECIALIST ONLY

Restricted to use where a metabolically neutral atypical antipsychotic is required and aripiprazole is not suitable due to contraindication or intolerance

 
Link  SEL APC recommendation - Lurasidone for the treatment of schizophrenia in adults aged 18 years and over
   
Olanzapine tabs, orodispersible tabs
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
   
Quetiapine tabs
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
   
Risperidone tabs, liquid, orodispersible tabs
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Restricted Drug Restricted
Amber 2
INITIATION BY SPECIALIST ONLY 
   
 ....
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 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

Red

Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. 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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