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South Staffordshire Joint Formulary
Cannock Chase Clinical Commissioning Group
East Staffordshire Clinical Commissioning Group
South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group
Stafford and Surrounds Clinical Commissioning Group
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 Formulary Chapter 4: Central nervous system - Full Chapter
04.03  Expand sub section  Antidepressant drugs
04.03.01  Expand sub section  Tricyclic and related antidepressant drugs
04.03.01  Expand sub section  Tricyclic antidepressants
Lofepramine
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Formulary
Green
Lofepramine HCl Tablet 70mg 
   
Amitriptyline
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Formulary
Green
Amitriptyline HCl Tablet 10mg
Amitriptyline HCl Tablet 25mg
Amitriptyline HCl Tablet 50mg
Amitriptyline HCl Oral Solution 25mg/5ml S/F
Amitriptyline HCl Oral Solution 50mg/5ml S/F
 
   
Clomipramine
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Formulary
Green
Clomipramine HCl Capsule 10mg
Clomipramine HCl Capsule 25mg
Clomipramine HCl Capsule 50mg
 
   
Dosulepin
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Formulary
Amber

Dosulepin HCl Capsule 25mg
Dosulepin HCl Tablet 75mg

NOT for new patients - more toxic in overdose. (MHRA December 2007).

NHS England has identified this product as an item that should not be routinely prescribed in primary care. Where ongoing primary care prescribing is agreed in exceptional circumstances, there should be a co-operative relationship within a multidisciplinary team (July 2017).

 
Link  Dosulepin 75 mg Tablets
   
04.03.02  Expand sub section  Monoamine-oxidase inhibitors
04.03.03  Expand sub section  Selective serotonin re-uptake inhibitors to top
Sertraline
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First Choice
Green
Sertraline HCl Tablet 50mg
Sertraline HCl Tablet 100mg
 
Citalopram
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First Choice
Green
Citalopram Hydrobromide Tablet 10mg
Citalopram Hydrobromide Tablet 20mg
Citalopram Hydrobromide Tablet 40mg
Citalopram HCl Oral Drops 40mg/ml S/F

Cost effective choice in patients where QT interval prolongation is not an issue (see MHRA advice below for detail) Maximum daily dose 40 mg for adults; 20 mg for patients older than 65 years; and 20 mg for those with hepatic impairment. 
Escitalopram (Cipralex)
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Formulary
Green

Escitalopram Tablet 5mg
Escitalopram Tablet 10mg
Escitalopram Tablet 20mg
Escitalopram Oral Drops 10mg/ml S/F


See MHRA advice on QT prolongation. Maximum daily dose 20 mg for adults; 10 mg for patients older than 65 years; and 10 mg for those with hepatic impairment.

 
Link  Citalopram and escitalopram: QT interval prolongation
   
Fluoxetine
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Formulary
Amber E

Treatment in Adolescents

Fluoxetine HCl Capsule 20mg
Fluoxetine Liquid 20mg/5ml (Prescribe Liquid for doses less than 20mg)

See link below for ESCA's. 

Please use the ESCA's under the title Agreements - South Staffordshire CCG Locality

 
Link  Essential Shared Care Aggreements - SSSFT
   
Fluoxetine
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Formulary
Green
Treatment in Adults

Fluoxetine HCl Capsule 20mg
Fluoxetine 20mg orodispersible tablets

Use the orodispersible tablets where there are swallowing difficulties or patient is on a 10mg dose as the tablet can be divided into equal halves to get the correct dose. This is much more cost effective then the oral solution 
   
Paroxetine
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Formulary
Amber
Paroxetine HCl Tablet 20mg
Paroxetine HCl Tablet 30mg
Paroxetine Oral Suspension 10mg/5ml SF

Withdrawal syndrome is more common with paroxetine - Royal College of Psychiatrists 
Link  Coming off antidepressants
   
Vortioxetine (Brintellix)
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Formulary
Amber

5mg Tablets
10mg Tablets
20mg Tablets

 

Vortioxetine is recommended as an option for treating major depressive

episodes in adults whose condition has responded inadequately to

2 antidepressants within the current episode.

 

 
Link  TA367 - Vortioxetine for treating major depressive episodes
   
04.03.04  Expand sub section  Other antidepressant drugs
Venlafaxine Tablets
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Formulary
Green
Venlafaxine Capsules 75mg
 
   
Venlafaxine M/R capsules
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Formulary
Green
Venlafaxine Capsules 75mg M/R
Venlafaxine Capsules 150mg M/R
Venlafaxine Capsules 225mg M/R (prescribe 225mg strength as Vensir)

Drug tariff price for 75mg and 150mg capsules now based on Vensir so can be prescribed generically

Please note licensed in depression and not anxiety
 
   
Venlafaxine M/R Tablets
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Formulary
Green
Venlafaxine tablets 75mg M/R
Venlafaxine tablets 150mg M/R
Venlafaxine tablets 225mg M/R

Prescribe generically.

Please note first line is Vensir mr caspules for depression
However the tablets are licensed in anxiety.
 
   
Mirtazapine
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Formulary
Green
Mirtazapine Tablet 15mg
Mirtazapine Tablet 30mg
Mirtazapine Tablet 45mg

Mirtazapine Orodisper Tab 15mg
Mirtazapine Orodisper Tab 30mg
Mirtazapine Orodisper Tab 45mg

 
   
Duloxetine (Cymbalta)
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Formulary
Amber
Duloxetine HCl Capsule G/R 30mg
Duloxetine HCl Capsule G/R 60mg
 
   
 ....
 Non Formulary Items
Agomelatine  (Valdoxan)

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Non Formulary
 
Amitriptyline and perphenazine  (Triptafen)

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Non Formulary
 
Amitriptyline and perphenazine  (Triptafen-M)

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Non Formulary
 
Clomipramine  (Anafranil SR)

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Non Formulary
 
Clomipramine Hydrochloride  (Anafranil)

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Non Formulary
 
Dosulepin Hydrochloride  (Prothiaden®)

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Non Formulary
 
Doxepin  (Sinepin)

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Non Formulary
 
Fluoxetine  (Prozac®)

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Non Formulary
 
Flupentixol  (Fluanxol)

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Non Formulary
 
Fluvoxamine Maleate  (Faverin®)

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Non Formulary
 
Fluvoxamine Maleate  (Fluvoxamine®)

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Non Formulary
 
Imipramine

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Non Formulary
 
Isocarboxazid

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Non Formulary
 
Mirtazapine  (Zispin SolTab)

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Non Formulary Prescribe generically
 
Nortriptyline  (Allegron)

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Non Formulary
 
Paroxetine  (Seroxat®)

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Non Formulary
 
Phenelzine  (Nardil)

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Non Formulary
 
Reboxetine  (Edronex)

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Non Formulary
 
Sertraline  (Lustral®)

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Non Formulary
 
Tranylcypromine

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Non Formulary
 
Trimipramine  (Surmontil®)

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Non Formulary
 
Tryptophan

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Non Formulary
 
Trytophan  (Optimax®)

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Non Formulary
 
Venlafaxine  (Efexor XL)

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Non Formulary
 
Venlafaxine  (Foraven XL®)

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Non Formulary
 
Venlafaxine  (Valdoxan®)

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Non Formulary
 
Venlafaxine  (Venaxx XL®)

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Non Formulary
 
Venlafaxine  (Venlalic® XL)

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Non Formulary
 
Venlafaxine  (Winfex®)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs which require special consideration. These are drugs for Consultant Prescribing ONLY. They should not be prescribed in Primary Care.  

Amber

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care. For some drugs there may be a Ricad in place to aid the transition to primary care.  

Amber E

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care but also require and ESCA (Shared Care Agreement)   

Green

Suitable first-line drugs for implementation in Primary Care  

On Formulary

South Staffs Formulary Choice  

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