North East and North Cumbria
ICS Formulary
 
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4 Central nervous system
04-02-01 Second Generation Antipsychotic Drugs

Risperidone
Formulary
  • Note: risperidone orodispersible tablets should only be used in situations where the plain tablets are unsuitable.
Link  MHRA Drug Safety Update (Nov 2013): Risperidone and paliperidone: risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery

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Amisulpride
Formulary

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Aripiprazole
Formulary

  • Approved for schizophrenia in people aged 15 to 17 years in line with NICE.

  • Approved for moderate to severe manic episodes in young people aged 13 and older with bipolar I disorder NICE.

  • Aripriprazole 10mg & 15mg orodispersible tablets are approved for doses over 5mg for those patients who have difficulty swallowing.

  • Aripiprazole 1mg in 1ml oral solution is only for doses of 5mg or less, or when titrating patients on doses of increments of less than 5mg, in patients who have difficulty swallowing tablets.

  • To be used in accordance with NICE criteria.

  • Note: Aripiprazole 7.5mg/ml IM Injection is approved for use in rapid tranquilisation in patients with acute psychosis. Red Traffic Light NTW use only.


 

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

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Clozapine
Formulary
  • First choice in patients with treatment-resistant schizophrenia. 
Link  MHRA Drug Safety Alert (Oct 2017): Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus
Link  MHRA Drug Safety Update (Aug 2020): Clozapine and other antipsychotics: monitoring blood concentrations for toxicity

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Lurasidone Latuda®
Formulary

  • 18.5mg, 37mg and 74mg tablets

  • Approved for the treatment of schizophrenia in adults and adolescents aged 13 years and over 

Link  NTAG - Lurasidone Treatment Appraisal: Decision Summary

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Olanzapine
Formulary
  • Olanzapine orodispersible tablets should only be used in situations where the plain tablets are unsuitable. 
  • Olanzapine orodispersible tablets and injection are also approved for 2nd/3rd- line use in the management of delirium in critical care patients unlicensedunlicensed indication. Green plus
  •  10 mg injection Green plus
    • for rapid control of agitation and disturbed behaviours in patients with schizophrenia or manic episode, when oral therapy is not appropriate.
    • for delirium at end of life 
  • 210mg, 300mg & 405mg powder and solvent for suspension for long-acting injection (as olanzapine embonate monohydrate) Red

    • approved for the treatment of schizophrenia in adults within secure psychiatric services



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Quetiapine
Formulary

  • 25mg, 100mg, 150mg 200mg & 300mg tablets Green plus

  • 50mg, 200mg, 300mg & 400mg prolonged release tablets Green plus 


    • Prolonged release tablets are approved for use in patients who require an outside carer to administer their medicines, and for short term use when rapid dose titration is considered important e.g. where its use might avoid the need to admit the patient to hospital.



  • Quetiapine 20mg/ml Oral Suspension (Rosemont) - CNTW only Red 


 


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