Antipsychotics - first and second generations
There is increased risk of stroke and transient ischaemic attack when antipsychotics are used in elderly people with dementia. Please see prescribing advice from the BNF.
Drug Safety Update
December 2023: Aripiprazole (Abilify and generic brands): risk of pathological gambling
December 2021: Haloperidol (Haldol): reminder of risks when used in elderly patients for the acute treatment of delirium
August 2020: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity
October 2017: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction and paralytic ileus
June 2009: Antipsychotics and risk of thromboembolic events
First and second generation NICE guidance
CG 178 Psychosis and schizophrenia in adults - prevention and management, March 2014
Kent and Medway NHS and Social Care Partnership (KMPT) Formulary has detailed prescribing information for the treatment of psychosis and related disorders
Psychosis and related disorders
Rapid tranquilisation
For patients admitted on or recommended Lurasidone or Melperone please see KMPT formulary for more information.
| Pack |
|---|
| 30 tablet |
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 30 tablet |
| 60 tablet |
| Pack |
|---|
| 60 ml |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 150 ml |
Important safety information
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 (aripiprazole400-mg vial with solvent), which are usually used in the community or clinics for maintenance treatment.
| Pack |
|---|
| 1 vial |
Chlorpromazine has a marked sedating effect and may be useful for treating violent patients. It has also been used in the treatment of persistent hiccups see NICE clinical knowledge summary.
| Pack |
|---|
| 28 tablet (2 x 14 tablets) |
| Pack |
|---|
| 28 tablet (2 x 14 tablets) |
| Pack |
|---|
| 28 tablet (2 x 14 tablets) |
| Pack |
|---|
| 150 ml |
| Pack |
|---|
| 10 ampoule |
Licensed for the symptomatic treatment of depression (with or without anxiety)
| Pack |
|---|
| 60 tablet (6 x 10 tablets) |
Licensed for the symptomatic treatment of depression (with or without anxiety)
| Pack |
|---|
| 60 tablet (6 x 10 tablets) |
Licensed for the treatment of schizophrenia and other psychoses.
| Pack |
|---|
| 100 tablet |
First line for non-specialist use.
Note: The injection is licensed via the IM route only. It is accepted that it can be used off-license via the IV route in the critical care setting only. There is a greater risk of prolonged QT interval and other side effects with the IV route. Monitor the patient's ECG and for any extra-pyramidal side effects.
| Pack |
|---|
| 100 tablet |
| 1000 tablet |
| 28 tablet |
| 30 tablet |
| Pack |
|---|
| 100 tablet |
| 250 tablet |
| 28 tablet |
| 30 tablet |
| Pack |
|---|
| 100 tablet |
| 20 tablet |
| 28 tablet |
| 30 tablet |
| 50 tablet |
| Pack |
|---|
| 100 ml |
| Pack |
|---|
| 10 ampoule |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| 56 tablet |
| Pack |
|---|
| 28 tablet |
| 56 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
Patients can be initiated on modified release formulation but all patients should be considered for a switched to immediate release once an optimal dose is established (see attached link to policy)
If XL is needed for clinical reasons then prescribe by branded generically.
| Pack |
|---|
| 30 tablet |
| 6 tablet |
| 60 tablet |
| Pack |
|---|
| 2 tablet |
| 60 tablet |
| Pack |
|---|
| 2 tablet |
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 20 tablet |
| Pack |
|---|
| 20 tablet |
| 6 tablet |
| 60 tablet |
| Pack |
|---|
| 60 tablet |
| Pack |
|---|
| 20 tablet |
| 60 tablet |
| Pack |
|---|
| 20 tablet |
| 60 tablet |
| Pack |
|---|
| 28 tablet |
| 30 tablet |
| 60 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 28 tablet |
| Pack |
|---|
| 30 tablet |
| Pack |
|---|
| 30 tablet |
| Pack |
|---|
| 150 ml |
| Pack |
|---|
| 112 tablet |
| Pack |
|---|
| 112 tablet (8 x 14 tablets) |
| Pack |
|---|
| 150 ml |
| Pack |
|---|
| 100 tablet |
| Pack |
|---|
| 100 tablet |
| Pack |
|---|
| 100 tablet |
Restricted to initiation by specialist mental health consultants only, it used for treatment resistant psychosis and schizophrenia.
Smoking reduces plasma levels by up to 50%
Please check the Summary of Product Characteristics (SPC) for information on monitoring and side effects
Always follow the KMPT trust policy for initiation in hospital or in the community
KMPT Policies for prescribing of clozapine
| Pack |
|---|
| 100 tablet |
| 28 tablet (2 x 14 tablets) |
| 84 tablet (6 x 14 tablets) |
| Pack |
|---|
| 100 tablet |
| 28 tablet (2 x 14 tablets) |
| 84 tablet (6 x 14 tablets) |
- On Formulary Preferred
- On Formulary Second Line
- On Formulary Third Line
- Specialist Initiation
- Secondary Care Only
- Not Approved for Formulary