Formulary Search

Dose adjustment required for liquid (10mg tablet = 8mg Oral Drops (4 drops) - see SPC for dose equivalence)

Fluoxetine dispersible tablets are the more cost effective option in patents without dysphagia.

Fluoxetine oral solution and dispersible tablets are clinically interchangable for oral use.

Liquid formulation is not cost effective; consider orodispersible tablets.

100mg/5ml concentrate for oral solution - REQUIRES DILUTION

Reserve for patients who require a liquid formulation where an alternative SSRI liquid (citalopram drops, escitalopram drops or fluoxetine liquid) are not suitable.
Note – Dose must be diluted with 120mL of water, ginger ale, lemon/lime soda, lemonade or orange juice.

Dilution instructions are provided in the patient information leaflet: Sertraline 100mg/5ml concentrate for oral solution PIL

50mg/5ml oral suspension

Reserve for patients who require a liquid formulation only where:
- an alternative SSRI liquid (citalopram drops, escitalopram drops or fluoxetine liquid) are not suitable
- the patients is unable to manage the dilution of sertraline 100mg/5ml concentrate oral solution

In Primary Care, OptimiseRx will be used to recommend the most cost-effective formulation at the point of prescribing. 

For treating major depressive episodes in line with NICE TA367.

Initiation and stabilisation by the Mental Health specialist team for a minimum of 3 months before any transfer of prescribing.

Exception - the specialist team may request this treatment is restarted in patients who have previously benefitted.

Not for routine initiation in new patients - risks of toxicity in overdose.

Initiation and stabilisation by the Mental Health specialist team for a minimum of 3 months before any transfer of prescribing.

Not for routine initiation in new patients - risks of toxicity in overdose.

Initiation and stabilisation by the Mental Health specialist team for a minimum of 3 months before any transfer of prescribing.

Lower strengths licensed for depression (0.5mg and 1mg tablets).
NICE CG for depression recommends antipsychotics (second generation) as augmentation therapy and to be initiated by a specialist. 
Therefore, flupentixol is not mentioned in the NICE CG for depression.
 

Initiation and stabilisation by the mental health specialist team for a minimum of 6 months before any transfer of care.

• Prophylaxis of depressive episodes in bipolar disorder.
• Prophylaxis of recurrent depression (off-label use).

Initiation and stabilisation by the specialist mental health team for at least 1 month before any request for transfer of prescribing responsibility to primary care.

NOTE - brand prescribing is not required for mood stabilisation. Prescribe generically.

Risk of rash on treatment initiation or after a treatment break.

• Prophylaxis of depressive episodes in bipolar disorder.
• Prophylaxis of recurrent depression (off-label use).

Initiation and stabilisation by the specialist mental health team for at least 1 month before any request for transfer of prescribing responsibility to primary care.

NOTE - brand prescribing is not required for mood stabilisation. Prescribe generically.

Risk of rash on treatment initiation or after a treatment break.

Reserve for use in patients who are unable to swallow tablets.

Prophylaxis of recurrent depression

Prescribe by BRAND. Lithium carbonate and lithium citrate are not equivalent.

Initiation and stabilisation by the specialist mental health team for at least 1 month before any request to transfer prescribing responsibility to primary care.

Prophylaxis of recurrent depression.

Prescribe by BRAND. Lithium carbonate and lithium citrate are not equivalent.

Initiation and stabilisation by the specialist mental health team for at least 1 month before any request to transfer prescribing responsibility to primary care.

Initiation and stabilisation by specialist for a minimum of 6 months before any transfer of prescribing responsibility is requested.

Initiation and stabilisation by mental health specialist team for a minimum of 6 months before transfer of prescribing responsibility may be requested.

Adjunctive treatment of major depression.

Initiation and stabilisation by a Mental Health specialist for a minimum of 1 month before any request for transfer of prescribing responsibility.

Adjunctive treatment of major depression.

Modified release tablets are reserved for use when immediate release tablets are not suitable.

Modified release quetiapine MAY be continued in Primary Care (after a 1-month period of stabilisation by a Mental Health specialist) where the use of immediate release tablets would risk destabilising the patient.

Initiation and stabilisation by mental health specialist team for a minimum of 6 months before transfer of prescribing responsibility may be requested.

Initiation and stabilisation by the Mental Health specialist team for a minimum of 3 months before any transfer of prescribing.

Not for routine initiation in new patients - risks of toxicity in overdose.

Initiation and stabilisation by the Mental Health specialist team for a minimum of 3 months before any transfer of prescribing.

Not for routine initiation in new patients - risks of toxicity in overdose.

To prescribe as 50mg/5ml oral solution sugar free.

Note - the 100mg/5ml is very expensive and should not be prescribed.

Initiation and stabilisation by the Mental Health specialist team for a minimum of 3 months before any transfer of prescribing.

Not for routine initiation in new patients - risks of toxicity in overdose.

Use capsules where possible. Trazodone 50mg and 100mg tablets are disproportionately expensive and should not be prescribed if a capsule could be used.

Patients who are established on this treatment for depression, and have been receiving prescriptions in Primary Care, may continue to do so.

Not for initiation in new patients.

Existing patients may remain on therapy providing cardiac risk and toxicity has been considered. It is advised that patients who present with deterioration of mental health may require a review by the specialist.