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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  Second-Generation Antipsychotic Drugs
Risperidone
(Oral)
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First Choice

Amber Traffic Light  First choice treatment in psychosis and schizophrenia. Suitable for continuation in primary care following specialist recommendation in line with Treatment of psychosis and schizophrenia algorithm

Restricted Item Brown Traffic Light  First-line (off license use) for the treatment of psychosis or for persistent aggression in dementia in line with Antipsychotic Use for Behavioural and Psychiatric Symptoms of Dementia Prescribing Guidance. Prescribing Points October 2011. For details please email OCCG.medicines@nhs.net

APCO September 2011.

 
Aripiprazole
(Orodispersible)
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Formulary
Amber Continuation

Only if recommended by secondary care in patients with swallowing difficulty or where supervised consumption is needed.

APCO November 2006.

 
   
Amisulpride
(Oral)
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Formulary

Amber Traffic Light Suitable for continuation in primary care following specialist recommendation in line with Treatment of psychosis and schizophrenia algorithm

Restricted Item Brown Traffic Light  Second-line (off license use) for short term use in line with Antipsychotic Use for Behavioural and Psychiatric Symptoms of Dementia Prescribing Guidance. Prescribing Points October 2011. For details please email OCCG.medicines@nhs.net

APCO September 2011.

 
   
Aripiprazole
(Tablet)
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Formulary

Red Traffic Light  For moderate to severe manic episodes in adolescents with bipolar disorder.

APCO September 2013.

Amber Traffic Light Suitable for continuation in primary care following specialist initiation for schizophrenia in people aged 15 to 17 years.

APCO May 2011.

Amber Traffic Light  Suitable for continuation in primary care following specialist recommendation in line with Treatment of psychosis and schizophrenia algorithm

APCO September 2004.

Restricted Item Brown Traffic Light  Second-line (off license use) for short term use in line with Antipsychotic Use for Behavioural and Psychiatric Symptoms of Dementia Prescribing Guidance. Prescribing Points October 2011. For details please email OCCG.medicines@nhs.net

APCO September 2011.

 
Link  NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years
Link  NICE TA292: Bipolar disorder (children) - aripiprazole
   
Aripiprazole
(Short acting IM injection)
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Formulary
Red

For secondary care psychiatrist prescribing only, in line with Treatment of psychosis and schizophrenia algorithm

 
   
Cariprazine
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Formulary
Red

Secondary care use only. 

 
   
Loxapine  (Adasuve®)
(Inhalation powder)
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Formulary
Red

For prescribing by Mental Health Specialists only.

APCO September 2017.

 
   
Lurasidone
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Formulary
Red

For schizophrenia.

Lurasidone is OFF-LABEL for bipolar depression. Any OH prescriber wishing to use lurasidone for this indication should complete an off-label request form and send it to the Drugs and Therapeutics Group (dtc@oxfordhealth.nhs.uk).

See Treatment of psychosis and schizophrenia algorithm

APCO March 2015.

 
   
Olanzapine
(Oral)
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Formulary

Amber Traffic Light  Suitable for continuation in primary care following specialist recommendation in line with Treatment of psychosis and schizophrenia algorithm.

Restricted Item Brown Traffic Light  Second-line (off license use) for short term use in line with Antipsychotic Use for Behavioural and Psychiatric Symptoms of Dementia Prescribing Guidance. Prescribing Points October 2011. For details please email OCCG.medicines@nhs.net

APCO September 2011.

 
   
Olanzapine Oral lyophilisate (Zyprexa® Velotabs)
(Oral)
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Restricted Drug Restricted
Brown

ORODISPERSIBLE TABLETS are restricted for palliative or end of life care patients with swallowing difficulties and for patients with feeding tubes only.

 
   
Quetiapine  (Standard-release)
(Oral)
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Formulary

Amber Traffic Light  Suitable for continuation in primary care following specialist recommendation in line with Treatment of psychosis and schizophrenia algorithm

Restricted Item Brown Traffic Light  Second-line (off license use) for short term use in line with Antipsychotic Use for Behavioural and Psychiatric Symptoms of Dementia Prescribing Guidance. Prescribing Points October 2011. For details please email OCCG.medicines@nhs.net

APCO September 2011.

Black Traffic Light  For generalised anxiety disorder due to limited evidence suggesting no greater efficacy than antidepressants.

APCO July 2013.

 
Link  NICE Evidence summary: Quetiapine for generalised anxiety disorder
   
Quetiapine XL (Modified-release)
(Oral)
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Formulary
Red

Used in secondary care to initiate treatment. Secondary care will switch to standard release preparation following titration and prior to discharge to primary care.

No clinical evidence of increased tolerability compared to immediate release therapy. Licensing for immediate release and modified release same. Only anecdotal evidence of benefit in titration.

APCO July 2013.

 
Link  NICE Evidence summary: Quetiapine for generalised anxiety disorder
   
Sertindole (Serdolect®)
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Formulary
Red

Named patient drug. Specialist prescribing only.

 
   
Olanzapine
(Short-acting injection)
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Unlicensed Drug Unlicensed
Red

Specialist prescribing only in line with Treatment of psychosis and schizophrenia algorithm

Olanzapine IM is not licensed in the UK. Unlicensed preparations are available.

 
   
 ....
 Non Formulary Items
Ziprasidone  (Zeldox®)

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Non Formulary

Unlicensed in the UK.

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

Red: Medicines which should only be prescribed in secondary care by a specialist.  

Amber Continuation

Amber Continuation: Medicines which should be initiated or recommended by a specialist for continuation in primary care. The specialist must notify the GP that the prescribing responsibility has been transferred.   

Amber Shared Care Protocol

Amber Shared Care Protocol: Medicines which are appropriate to be initiated and stabilised by a specialist, once stabilised the medicine may be appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement. The shared care protocol must be approved by the Area Prescribing Committee Oxfordshire (APCO).   

Green

Green: Medicines which are suitable for initiation and ongoing prescribing within primary care.   

Brown

Brown: Medicines which should only be prescribed in restricted circumstances.  

Black

Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.  

OCCG Green

not used  

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