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Other antidepressants

Other antidepressant drugs Preparations Comments
Agomelatine 25mg tablets Named patient request ONLY. Prescribing to remain with HPFT – not to be transferred to primary care.
Risk of dose related hepatotoxicity and liver failure see MHRA Agomelatine (Valdoxan): risk of liver toxicity
Duloxetine hydrochloride 30mg and 60mg capsules Second line SNRI only after venlafaxine.
Flupentixol dihydrochloride 500micrograms and 1mg tablets Not appropriate choice as sole treatment of depression.
Mirtazapine 15mg, 30mg and 45mg tablets and orodispersible tablets
5mg/ml oral solution
Oral solution should only be used when orodispersible tablets are unsuitable.
Reboxetine 4mg tablets  
Venlafaxine 37.5mg and 75mg tablets
37.5mg, 75mg, 150mg and 225mg MR tablets
Immediate-release venlafaxine (BD dosage) is considerably less expensive than once daily (MR) formulations. The MR formulation should only be used if the immediate-release formulation is not tolerated or if concordance with a twice daily regimen is difficult.
If MR preparation is required then MR tablets should be prescribed rather than MR capsules as these more cost-effective.
Existing patients on MR preparations must not be switched to IR tablets without involvement/agreement of psychiatrist.
 Vortioxetine 5mg, 10mg and 20mg tablets

GPs can initiate once specialist advice has been sought from a HPFT Consultant Psychiatrist. NICE recommends that vortioxetine is an option for treating major depression in adults who have responded inadequately to two antidepressamts within the current episode of depression. See Guidelines in Choice and Selection of antidepressants for the management of depression. 

 

 

Back to 4.3.2 Monoamine-oxidase inhibitors (MAOI's)

Back to 4.3.3 Selective serotonin re-uptake inhibitors (SSRI's)

Back to 4.3.1 Tricyclic and related anti-depressant drugs

Continue to 3.6 Psychoses and schizophrenia

 

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