The balance of risk and benefit should be considered and discussed with the patient or carers before prescribing antipsychotic drugs for elderly patients. In elderly patients with dementia, the use of antipsychotic drugs are associated with a small increased risk of mortality and an increased risk of stroke or transient ischaemic attack.
Amisulpride |
Formulary
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Tablets 50mg, 100mg, 200mg, 400mg Schizophrenia. |
LSCMMG: Shared care guideline MHRA: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity |
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Aripiprazole Abilify® |
Formulary
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Tablets 5mg,10mg,15mg, 30mg Orodispersible tablets and oral solution for use in swallowing difficulties only. Consultant psychiatrist initiation only. When prescribing, dispensing, or administering, check that the correct preparation is used—the preparation usually used in hospital for the rapid control of an acute episode (solution for injection containing aripiprazole 7.5 mg/mL) should not be confused with depot preparations (powder and solvent for prolonged-release suspension for injection), which are usually used in the community or clinics for maintenance treatment. Alternating hemiplegia under specialist supervision. |
LSCMMG: Shared care guideline MHRA: Aripiprazole (Abilify and generic brands): risk of pathological gambling MHRA: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 to 17 years NICE TA292: Aripiprazole for treating moderate to severe manic episodes in adolescents with bipolar I disorder |
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Cariprazine Reagila® |
Formulary
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Capsules 1.5mg, 3mg, 4.5mg, 6mg Schizophrenia in adult patients. Second-line therapy in patients where predominantly negative symptoms have been identified as an important feature. Requires prior approval by Lead Pharmacist before initiation. |
LSCFT - Cariprazine medicine request form LSCMMG: Shared care guideline |
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Clozapine |
Formulary
|
Tablets 25mg, 100mg Liquid 100mg/5mL Injection Treatment resistant/intolerant schizophrenia Psychosis in LSCFT use only - Clinicains to refer to the clozapine procedure. |
LSCFT - Clozapine injection medication request form |
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Lurasidone Latuda® |
Formulary
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Tablets 18.5mg, 37mg, 74mg Schizophrenia in adults aged 13 and over. LSCFT initiated only Lurasidone will be supplied by the specialist service for the duration of the treatment course. |
LSCFT - Lurasidone medicine request form |
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Olanzapine |
Formulary
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Tablets 2.5mg, 5mg, 7.5mg, 10mg, 15mg Schizophrenia and moderate to severe manic episodes and preventing reoccurrence in bipolar disorder. |
LSCMMG: Shared care guideline MHRA: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity |
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Quetiapine |
Formulary
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Tablets, m/r tablets. Please prescribe MR tablets by brand. The XL version is only version licensed as an add-on treatment of major depressive episodes in patients with Major Depressive Disorder who have had sub-optimal response to antidepressant monotherapy. Brancico XL, Zaluron XL tablets, Sondate XL 150mg, XL 200mg, XL 300mg, XL 400mg tablets [PRESCRIBE BY BRAND]. LSCFT initiated only Schizophrenia, manic episodes associated with bipolar disorder, major depressive episodes in bipolar disorder, preventing recurrence in bipolar disorder. LSCFT: Approval should be sought from Locality Lead Pharmacist prior to initiation of XL for major depressive disorder. |
LSCFT - Quetiapine XL medicine request form LSCMMG: Shared care guideline |
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Risperidone |
Formulary
|
Tablets 500micrograms, 1mg, 2mg, 3mg, 4mg Schizophrenia, moderate to severe manic episodes associated with bipolar disorders, shortterm treatment (up to 6 weeks) of persistent aggression in patients with moderate to severe Alzheimer's dementia unresponsive to non-pharmacological approaches and when there is a risk of harm to self or others, short-term symptomatic treatment (up to 6 weeks) of persistent aggression in conduct disorder in children from the age of 5 years and adolescents with subaverage intellectual functioning or mental retardation diagnosed according to DSM-IV criteria, in whom the severity of aggressive or other disruptive behaviours require pharmacologic treatment. May be used for longer periods (off-label) in conduct disorder with autistic spectrum condition or severe learning disability. |
LSCMMG: Shared care guideline MHRA: Recent drug-name confusion MHRA: Risperidone and paliperidone: risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery |
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