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FORMULARY

This policy supersedes all previous policies for Insert Name of Policy/Guideline/Protocol or delete if new

October 2008

policy title

FORMULARY

policy reference

policy category

relevant to

date published

OCTOBER 2008

implementation date

OCTOBER 2008

date last reviewed

SEPTEMBER 2008

next review date

SEPTEMBER 2010

responsible person

AUDREY COKER, LEA D MENTAL HEALTH PHARMACIST

contact details

Email: [email address]

Telephone: 020 7561 4128

accountable director

Insert name, DR SYLVIA TANG, MEDICAL DIRECTOR

Signature and date

approved by

Mental Health Policy and Practice Group

Date: Insert Date

approved by

Risk and Assurance Committee

Date: Insert Date

approved by

Drugs and Therapeutics Committee

Date: September 2008

approved by

Clinical Governance Committee

Date: Insert Date

document history

Date

Version

Amendments

membership of the policy development/ review team

Audrey Coker, Lead Mental Health Pharmacist

consultation

Drugs and Therapeutics Committee

DO NOT AMEND THIS DOCUMENT

Further copies of this document can be found on the Care Trust intranet.

CONTENTS

Page

1.

INTRODUCTION

1

2.

AIMS AND OBJECTIVES

1

3.

BETA BLOCKERS (PRESCRIBED FOR AUTONOMI CSYMPTOMS OF ANXIETY)

1

4.

HYPNOTICS AND ANXIOLYTICS

1

5.

HYPNOTICS

1

6.

ANXIOLYTICS

1

7.

TYPICAL ANTIPSYCHOTIC DRUGS

1

8.

ATYPICAL ANTIPSYCHOTIC DRUGS

2

9.

ANTIPSYCHOTIC DEPOT INJECTIONS

2

10.

ANTIMANIC DRUGS

2

11.

TRICYCLIC ANTIDEPRESSANTS

2

12.

MONOAMINE OXIDASE INHIBITORS 9& REVERSIBLE MAOIs)

2

13

SELECTIVE SEROTONIN REUPTAKE INHIBITORS

3

14

OTHER ANTIDEPRESSANT DRUGS

3

15

DRUGS IN NAUSEA AND VERTIGO (PRESCRIBED FOR HYPERSALIVATION)

3

16

ANTIEPILEPTiCS (PRESCRIBED AS MOOD STABILISERS)

3

17

DRUGS FOR EPILEPSY (PRESCRIBED AS ANXIOLYTICS)

3

18

ANTIMUSCARINIC DRUGS USED IN PARKINSONISM

3

19

DRUGS USED IN SUBSTANCE MISUSE

3

20

ACETYLCHOLINESTESRASES

4

21

VITAMIN B GROUP

4

22

NUTRITION (PRESCRIBED FOR SIDE EFFECTS IN PRACTICE)

4

23

TREATMENT FOR GLAUCOMA (PRESCRIBED FOR HYPERSALIVATION IN PRACTICE)

4

24

UNLICENSED MEDICINES

4

25.

DISSEMINATION AND IMPLEMENTATION

4

26.

AUDIT AND REVIEW

4

27.

REFERENCES

5


1. INTRODUCTION

The following medicines have been approved for use in Camden and Islington Mental Health Foundation Trust by the Drugs and Therapeutics Committee.

2. AIMS AND OBJECTIVES

  1. To support evidence based prescribing.

  2. To promote drug expenditure monitoring.

  3. To improve access to medicines with minimal delay

CHAPTER 4: CENTRAL NERVOUS SYSTEM BNF CATEGORY

3. Beta Blockers (Prescribed for autonomic symptoms of anxiety) 2.4

4. Hypnotics and anxiolytics 4.1

Please be aware that some of these medications have been known to worsen hallucinations or psychosis. In some instances (zolpidem, nitrazepam, loprazolam and diazepam) it is listed as a contraindication. The Drugs and Therapeutics Committee have reviewed the evidence for this and maintain that where possible the use of these groups of medicines should be used where the benefit outweigh the risk. It is important to note that where medicines are used outside the product license, the individual clinician is then responsible for its use.

5. Hypnotics 4.1.1

6. Anxiolytics 4.1.2

(Also 4.8.2.)

7. Typical Antipsychotic drugs 4.2.1

BNF

CATEGORY

8. Atypical antipsychotics 4.2.1

9. Antipsychotic depot injections 4.2.2

10. Antimanic drugs 4.2.3

ANTIDEPRESSANT DRUGS

11. Tricyclic and related antidepressant drugs 4.3.1

12. Monoamine Oxidase Inhibitors 4.3.2

BNF

CATEGORY

Reversible MAOIs

13. Selective Serotonin Reuptake Inhibitors 4.3.3

14. Other antidepressant drugs 4.3.4

15. Drugs used in nausea and vertigo (prescribed for 4.6

hypersalivation in practice)

16. Antiepileptics (prescribed as mood stabilizers) 4.8.1

17. Drugs for Epilepsy (prescribed as anxiolytics) 4.8.2

18. Antimuscarinic drugs used in Parkinsonism 4.9.2

19. Drugs used in substance dependence 4.10

Alcohol dependence

BNF

CATEGORY

Cigarette smoking

Opioid dependence

20. Drugs for dementia 4.11

21. Vitamin B Group 9.6.3

22. Nutrition (prescribed side effects in practice) 9.6.5

23. Treatment for Glaucoma (prescribed for hypersalivation 11.5

in practice)

24. Unlicensed Medicines

Some of the above are prescribed or may be prescribed for unlicensed (off label) indications. These entail extra legal responsibilities for prescribers and the Trust. The consultant needs to be aware of times where off label medicines are being used. The Trust policies for `off label' prescribing must be adhered to.

25. DISSEMINATION AND IMPLEMENTATION

This document will be circulated to all managers who will be required to cascade the information to members of their teams and to confirm receipt of the procedure and destruction of previous procedures/policies which this supersedes. It will be available to all staff via the Care Trust intranet. Managers will ensure that all staff are briefed on its contents and on what it means for them.

26. AUDIT AND REVIEW

This formulary will be audited via a review of non formulary requests to the Pharmacy.

This policy will be reviewed in October 2010

27. REFERENCES

The Brtish National Formulary. Number 55.

2

Insert draft number - insert date Ref: Insert reference

Insert name of policy

Insert draft number - insert date