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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 
                                    capsules 500 micrograms
                                    oral liquid 2mg/mL    
                                    injection 5mg/mL
         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    
       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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public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service 
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