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
 Formulary Chapter 4: Central nervous system - Full Chapter

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

04.08.01  Expand sub section  Control of epilepsy
04.08.01  Expand sub section  Carbamazepine and Oxcarbazepine
04.08.01  Expand sub section  Ethosuximide
04.08.01  Expand sub section  Gabapentin and pregabalin
04.08.01  Expand sub section  Lacosamide to top
04.08.01  Expand sub section  Lamotrigine
04.08.01  Expand sub section  Levetiracetam
04.08.01  Expand sub section  Perampanel
04.08.01  Expand sub section  Phenobarbital and other barbiturates
04.08.01  Expand sub section  Phenytoin to top
04.08.01  Expand sub section  Retigaine
04.08.01  Expand sub section  Rufinamide
04.08.01  Expand sub section  Tiagabine
04.08.01  Expand sub section  Topiramate
04.08.01  Expand sub section  Valproate to top
Sodium Valproate tabs, m/r tabs, oral solution, injection (epilepsy)
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Amber 2

Valproate must no longer be used in any girls or women able to have children unless she agrees to comply with a pregnancy prevention programme.

All women and girls who are prescribed valproate should contact their GP and arrange to have their treatment reviewed.

Communication materials have been provided by the manufacturers to discuss the risk of abnormal pregnancy outcomes with women and girls of childbearing potential. See links below.

Link  Valproate Annual Risk Acknowledgement Form
Link  Valproate- Patient Guide-Educational material- Pregnancy prevention programme
Link  Valproate- Healthcare professionals (HCPs) Educational material Pregnancy prevention programme
Link  MHRA Mar 2018: Valproate use by women and girls
Link  MHRA Apr 2017: Valproate and developmental disorders: new alert asking for patient review and further consideration of risk minimisation measures
Link  MHRA Feb 2016: Valproate and risk of abnormal pregnancy outcomes: new communication materials
04.08.01  Expand sub section  Vigabatrin
04.08.01  Expand sub section  Zonisamide
04.08.01  Expand sub section  Benzodiazepines
04.08.01  Expand sub section  Other Drugs
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
Track Changes
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Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
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High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHS England

Traffic Light Status Information

Status Description


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  


Specialist and non-specialist initiation  


Not recommended for prescribing