Oral Antipsychotic Drugs

NHSL Medicines Guidance
NHS Lanarkshire

General Notes

There is no formulary preferred option as prescribers should seek specialist advice before commencing treatment. Treatment may be initiated in primary care following specialist advice or referring to the local NHS Lanarkshire and National guidelines (see General Notes: Drugs Used in Psychoses and Related Disorders).

Any new presentations of psychotic symptoms would be expected to result in a referral to the appropriate mental health service.

All antipsychotics carry a considerable risk of side-effects.

Delirium may be managed without specialist mental health input if uncomplicated and with reference to local guidance (NHS Lanarkshire Delirium Guidelines).

The Choice and Medication website offers patient information about mental health conditions and the treatments available to help make informed decisions about choosing the right medicine: www.choiceandmedication.org/nhs24/

Oral Antipsychotic Drugs

Total list (T)

ARIPIPRAZOLE tablets

RISPERIDONE tablets

QUETIAPINE tablets

HALOPERIDOL tablets

  • Haloperidol should not be initiated without an up to date ECG being available.

 

Specialist initiation (S1)

OLANZAPINE tablets

  • Olanzapine Velotab preparation is non-formulary.
  • Where dispersible tablets are required prescribe as orodispersible tablets.

AMISULPRIDE tablets

FLUPENTIXOL tablets

ZUCLOPENTHIXOL tablets

LEVOMEPROMAZINE tablets

  • For treatment of terminal delirium in palliative care only

Scottish Palliative Care Guidelines

 

Specialist use only (S2)

CLOZAPINE tablets

  • Clozapine should only be initiated in Secondary Care and will be dispensed through Hospital Pharmacy, with appropriate monitoring following the local protocol.

Clozapine Standards for Mental Health and Learning Disability Services

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 29/11/2023

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.