Oxfordshire Clinical Commissioning Group
Formulary
 
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4 Central nervous system
04-03-04 Other antidepressant drugs

Mirtazapine
First Choice

First choice antidepressant if sedation is required, or if SSRI related adverse effects are unacceptable (GI bleeding, hyponatraemia, sexual dysfunction, insomnia).

See Prescribing Guidelines for the Management of Moderate to Severe Depression.


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Flupentixol Fluanxol®
Formulary

Suitable for prescribing in primary care following specialist recommendation.


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Venlafaxine
Formulary

Green Traffic Light  For the treatment and management of depression in adults as per NICE CG90. See Prescribing Guidelines for the Management of Moderate to Severe Depression.

Monitor blood pressure. Prominent withdrawal symptoms. No evidence that it has a greater efficacy than sertraline or mirtazapine even at higher dose.

APCO January 2017.

Black Traffic Light  Not licensed for controlling hot flushes. Not recommended for prescribing. 

APCO November 2005.


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Venlafaxine XL Vensir® XL
Formulary

Green Traffic Light  For Generalised Anxiety Disorder:

 

Green Traffic Light  For moderate to severe depression:



NB. Vensir® XL capsules is the most cost-effective prolonged-release formulation, see Prescribing Points March 2017.

APCO March 2017.

Black Traffic Light  Not licensed for controlling hot flushes. Not recommended for prescribing. 

APCO November 2005.


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Duloxetine
Formulary

Green Traffic Light  Alternative first line options when an SSRI is contraindicated for Generalised Anxiety Disorder. See Primary Care Generalised Anxiety Disorder Guideline for Adults and Older Adults.

APCO September 2017.

Amber Traffic Light  Suitable for prescribing in primary care following specialist recommendation. See Prescribing Guidelines for the Management of Moderate to Severe Depression.

APCO March 2005.


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Reboxetine
Formulary

Suitable for prescribing in primary care following specialist recommendation.

Consider only if serotonergic effect is intolerable. Evidence for efficacy not as robust as others.

See Prescribing Guidelines for the Management of Moderate to Severe Depression.


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Vortioxetine Brintellix®
Formulary

Suitable for prescribing in primary care following specialist recommendation as per Oxford Health Medicines Information Bulletin: Vortioxetine for depression.

Option for treating major depressive episodes in adults whose condition has responded inadequately to 2 antidepressants within the current episode as per NICE TA367.

APCO May 2016.

Link  NICE TA367: Vortioxetine for treating major depressive episodes
 

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Agomelatine Valdoxan®
Formulary

Specialist prescribing only.

Fourth line treatment for Generalised Anxiety Disorder. See Primary Care Generalised Anxiety Disorder Guideline for Adults and Older Adults.

APCO September 2017.

Also see Prescribing Guidelines for the Management of Moderate to Severe Depression.

APCO July 2017. 


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Tryptophan
Non Formulary

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