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Joint Formulary  
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 Formulary Chapter 4: Central nervous system - Full Chapter
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04.02.01  Expand sub section  Antipsychotic Drugs
04.02.01  Expand sub section  First-Generation Antipsychotic Drugs
04.02.01  Expand sub section  Second-Generation Antipsychotic Drugs
Amisulpride
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Nil
  • RFL approvals:
    • Restricted for initiation until after a discussion with liaison psychiatry team.
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Restricted for initiation by a Consultant Psychiatrist only.
 
   
Aripiprazole
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Restricted Drug Restricted
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Intramuscular formulation (7.5mg/1mL) is approved for the rapid control of agitation and disturbed behaviours in adult patients with schizophrenia or with manic episodes in Bipolar I Disorder when oral therapy is not appropriate and where IM haloperidol is not recommended. (JFC January 2019)

Secondary care notes

  • NMUH approvals:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary but NOT routinely stocked in pharmacy. This medicine will be ordered if use is as per local Trust Guideline or is approved by the Trust Medicines Management Committee. Contact pharmacy medicines information on ext 2417 for further information.
    • See links below
  • RFL approvals:
    • Restricted for initiation until after a discussion with liaison psychiatry team
  • RNOH approvals
    • Initiation with Psychiatry advice only
  • UCLH approvals:
  • WH approvals:
    • Restricted for initiation by a Consultant Psychiatrist only
 
Link  NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years
Link  NICE TA292: Bipolar disorder (children) - aripiprazole
   
Clozapine (Clozaril)
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Restricted Drug Restricted
GP - Red
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Secondary care notes

  • NMUH approvals:
    • Restricted to Consultant Psychiatrist use only
    • Monitoring required
    • See links below
  • RFL approvals:
    • Restricted for initiation until after a discussion with liaison psychiatry team
    • If a patient is admitted on this therapy please ensure that the pharmacy mental health team are aware.
    • Patients being treated in the UK will be registered with CPMS (Clozaril Patient Monitoring Service)
    • See links below
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Restricted for initiation by a Consultant Psychiatrist only
 
Link  NCL JFC: Guidance for Pharmacy Staff Managing Clozapine For Patients Admitted to Acute Hospitals
   
Olanzapine
(Antipsychotic)
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Restricted to Psychiatric department use only
    • Only for third line treatment of schizophrenia after using standard antipsychotics and risperidone
  • RFL approvals:
    • Restricted for initiation until after a discussion with liaison psychiatry team
  • RNOH approvals
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Restricted for initiation by a Consultant Psychiatrist only
 
   
Quetiapine
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Restricted to Consultant Psychiatrist use only
    • Second line medication
  • RFL approvals:
    • Restricted for initiation until after a discussion with liaison psychiatry team
  • RNOH approvals
    • Initiation with Psychiatry advice only
  • UCLH approvals:
  • WH approvals:
    • Restricted for initiation by a Consultant Psychiatrist only
 
   
Quetiapine modified release
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Formulary
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Not applicable
  • RNOH approvals
    • Initiation with Psychiatry advice only
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
   
Risperidone
(Antipsychotic)
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Restricted to Consultant Psychiatrist use only
    • Second line medication
  • RFL approvals:
    • Restricted for initiation until after a discussion with liaison psychiatry team
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Restricted for initiation by a Consultant Psychiatrist only
 
   
 ....
 Non Formulary Items
Clozapine  (Denzapine)

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Non Formulary
GP - Red
Link  NCL JFC: Guidance for Pharmacy Staff Managing Clozapine For Patients Admitted to Acute Hospitals
Link  NMUH: Trust Therapeutic Drug Monitoring Guidelines
 
Clozapine  (Denzapine)

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Non Formulary
GP - Red
Link  NCL JFC: Guidance for Pharmacy Staff Managing Clozapine For Patients Admitted to Acute Hospitals
Link  NMUH: Trust Therapeutic Drug Monitoring Guidelines
 
Clozapine  (Zaponex)

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Non Formulary
GP - Red
Link  NCL JFC: Guidance for Pharmacy Staff Managing Clozapine For Patients Admitted to Acute Hospitals
Link  NMUH: Trust Therapeutic Drug Monitoring Guidelines
 
Loxapine inhalation

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Non Formulary
Link  NICE TA286 (not recommended): Loxapine inhalation for treating acute agitation and disturbed behaviours associated with schizophrenia and bipolar disorder (terminated appraisal)
 
Lurasidone

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Non Formulary
Black

Not approved for schizophrenia (June 2015)

 
Paliperidone

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Non Formulary
 
Sertindole  (Serdolect)

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Non Formulary
 
Ziprasidone  (Zeldox)

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Non Formulary
 
Zotepine  (Zoleptil®)

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Non Formulary
 
  
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
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Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
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

GP - 1st

Medicines suitable for first-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - 2nd

Medicines suitable for second-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - Amber

Medicines that should be initiated by a specialist. Prescribing can be transferred to primary care once the patient has been stabilised.

Shared care: For drugs with regular, ongoing need for monitoring and/or assessment of efficacy or toxicity. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the North Central London JFC.

Fact sheet: For drugs with some concerns surrounding safety or efficacy but do not require regular monitoring and/or monitoring of effectiveness/toxicity.

  

GP - Red

Medicines which should normally be prescribed by specialists only (hospital only).

For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.

  

GP - Grey

Medicines on hospital formularies which have not been reviewed for suitability in primary care.  

Black

Medicines not recommended for routine use in primary or secondary care.

Medicines, which the North Central London JFC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.

  

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