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Initiation by a SABP specialist and stabilisation for at least 3 months before any request to transfer prescribing responsibility.

Second line treatment option in the management of schizophrenia once metabolic syndrome has been identified.

Initiation by a SABP specialist and stabilisation for a minimum of 3 months before any request to transfer prescribing responsibility.

Reserve for patients who are unable to swallow tablets.

Oro-dispersible tablets are more cost effectice than oral solution. Reserve oral solution for use in patients where the required dose is not available in an oro-dispersible form.

One monthly or two monthly injecton schedule available

• Monthly injection – Deltoid or gluteal muscle
• Injection every 2 months – Gluteal muscle only

For administration under the shared-care LCS when prescribed in Primary Care.

Where there is no LCS in place, the prescribing responsibility remains with SABP.

Secondary Care may prescribe for in-patients (on the instruction of a SABP specialist) and prescribing continued by SABP after discharge.

Relief of acute symptoms of psychoses.

Initiation by a SABP specialist and stabilisation for at least 3 months before any request to transfer prescribing responsibility.

Relief of acute symptoms of psychoses.

Initiation by a SABP specialist and stabilisation for a minimum of 3 months before any request to transfer prescribing responsibility.

Flupenthixol decanoate - administration under the shared-care LCS when prescribed in Primary Care.

See shared-care document below

Flupenthixol decanoate - where there is no LCS in place, the prescribing responsibility remains with SABP.

Secondary Care may prescribe for in-patients (on the instruction of a SABP specialist) and prescribing continued by SABP after discharge.

Off-label use.

Initiation by a SABP specialist and stabilisation for at least 3 months before any request to transfer prescribing responsibility.

Capsules are an unlicensed product.

Initiation by a SABP specialist and stabilisation for at least 3 months before any request to transfer prescribing responsibility.

Haloperidol decanoate - administration under the shared-care LCS when prescribed in Primary Care.

See shared care document below

Haloperidol decanoate - where there is no LCS in place, the prescribing responsibility remains with SABP.

Secondary Care may prescribe for in-patients (on the instruction of a SABP specialist) and prescribing continued by SABP after discharge.

Initiation by a SABP specialist and stabilisation for a minimum of 3 months before any request to transfer prescribing responsibility.

Initiation by a SABP specialist and stabilisation for a minimum of 3 months before any request to transfer prescribing responsibility.

Reserve orodispersible tablets for patients with swallowing difficulties or administration via a PEG tube. 

Initiation by a SABP specialist and stabilisation for a minimum of 3 months before any request to transfer prescribing responsibility.

Olanzapine embonate - maintenance in schizophrenia.
Not suitable for  administration under the locally commissioned service (LCS).
Note 3 hour monitoring after dose .

Initiation and stabilisation by a SABP specialist for a minimum of 3 months before any request for transfer of prescribing responsibility.

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 3-month period of stabilisation by SABP) where the use of immediate release tablets would risk destabilising the patient.

Initiation by a SABP specialist and stabilisation for at least 3 months before any request to transfer prescribing responsibility.

Initiation by a SABP specialist and stabilisation for at least 3 months before any request to transfer prescribing responsibility.

Initiation by a SABP specialist and stabilisation for a minimum of 3 months before any request to transfer prescribing responsibility.

Zuclopenthixol decanoate - under the LCS agreement once being prescribed in Primary Care.

In-patient administration only (SABP).

Administration under the shared-care LCS when prescribed in Primary Care.

See shared-care document below

Paliperidone palmitate - where there is no LCS in place, the prescribing responsibility remains with SABP.

Secondary Care may prescribe for in-patients (on the instruction of a SABP specialist) and prescribing continued by SABP after discharge.

SABP only - prescribing flowchart available via SABP.

Patient must be on highly effective contraceptive

Treatment resistant schizophrenia.
NOTE: patient, prescriber and supplying pharmacy must be registered with the patient monitoring system. 

MHRA/CHM advice: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity (August 2020)

MHRA/CHM advice: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus (October 2017)

Unlicensed drug.