4.2.1 Antipsychotics

4.2.1 Antipsychotics

4.2.1 Antipsychotic drugs

Link to Suggested Monitoring Requirements of High Risk Drugs
Used for conditions such as schizophrenia or in the short term to calm disturbed patient. Other less common uses are: treatment of nausea and vomiting, choreas, motor tics and intractable hiccup. Benperidol is specifically used for deviant antisocial sexual behaviour, to be initiated by a consultant.

RED Benperidol

tablets 250mcg

Pronounced sedative effects

GREEN Chlorpromazine

tablets 10mg, 25mg, 50mg, 100mg

syrup 25mg/5mL , syrup 100mg/5mL

GREEN Promazine

tablets 25mg, 50mg

oral solution 25mg/5mL

oral solution 50mg/5mL

Fewer sedative effects

GREEN Haloperidol

tablets 1.5mg, 5mg, 10mg

oral liquid 10mg/5mL, 5mg/ 5mL

injection 5mg/mL

**NB: Haloperidol capsules 500 micrograms have been discontinued.

BLACK Haloperidol 500mcg tablets [High Cost DO NOT PRESCRIBE]

For a dose of 500mcg, prescribe 0.5ml of 5mg in 5ml liquid

GREEN Sulpiride tablets 200mg

AMBER Flupentixol dihydrochloride

tablets 3mg

AMBER Trifluoperazine

(LCFT) tablets 1mg, 5mg

oral solution 5mg/5mL

AMBER Zuclopenthixol dihydrochloride

tablets 2mg, 10mg

RED Zuclopenthixol acetate

(LCFT) injection 50mg/mL

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Atypical antipsychotics

To be started by specialists only.

A shared care protocol is also available which outlines both the specialists and the GPs responsibilities - click here to access it.

Quetiapine XL formulation

The Drugs & Therapeutics Committee reviewed the current activity on the prescribing of the prolonged release form of Quetiapine. This formulation was approved by D&T in March 2009 subject to a prescribing guideline and initiation by a consultant. In light of the dramatic increase in the use of this product the D&T committee have made the decision to introduce an approval process. Quetiapine will become generic in 2012 and the current position regarding this formulation is unclear but it may be available as a generic product. This will place a significant cost burden on our primary care colleagues which in the current economic climate is open to challenge.

AMBER Amisulpride

SHARED CARE tablets 50mg, 200mg

liquid 100mg/mL

AMBER Aripiprazole tablets 10mg, 15mg, 30mg (consultant initiation only)

SHARED CARE Aripiprazole orodispersible tablets 10mg, 15mg (for use only when swallowing difficulties)

RED Aripiprazole tablets 10mg, 15mg, 30mg

(consultant use only for alternating hemiplegia)

RED Clozapine tablets 25mg, 100mg (consultant only)

AMBER Olanzapine tablets 2.5mg, 5mg, 7.5mg, 10mg, 15mg

SHARED CARE oro-dispersible 5mg, 10mg tablets

RED Olanzapine injection 5mg/mL

AMBER Quetiapine

SHARED CARE tablets 25mg, 100mg, 150mg, 200mg

m/r tablets 50mg, 200mg, 300mg, 400mg

m/r tablets to be prescribed by brand.

Brancico® XL 150mg, XL 200mg, XL 300mg, XL 400mg tablets [PRESCRIBE BY BRAND]

Zaluron XL tablets, Sondate XL tablets

AMBER Risperidone

SHARED CARE tablets 500 micrograms,1mg, 2mg, 3mg, 4mg

Quicklets® 500 micrograms, 1mg, 2mg

liquid 1mg/mL

AMBER

SHARED CARE Zotepine tablets 25mg, 50mg 100mg (consultant initiation only)

AMBER Cariprazine [Reagila®]

SHARED CARE capsules 1.5mg, 3mg, 4.5mg, 6mg

[Only to be used as second-line therapy (where clozapine is not appropriate] where predominantly negative

symptoms have been identified as an important feature - See Shared Care Guideline]

RED Lurasidone (Latuda®)

tablets fc 18.5mg, 37mg, 74mg

Specialist service use only

Click here for the New Medicine Recommendation for Lurasidone

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All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the

public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service

Email: info.elmmb@nhs.net