50mg, 100mg, 200mg tablets
100mg/ml oral solution (sugar free)
|400mg tablets are significantly more expensive than 200mg tablets.|
5mg, 10mg, 15mg and 30mg tablets
To be initiated by HPFT and then continued in primary care. Rationale for choice over other antipsychotics to be provided to GP.
Injection - for HPFT prescribing only
NICE TA292 Aripiprazole is recommended as an option for treatment of moderate to severe manic episodes in adolescents with bipolar 1 disorder, within it's marketing authorisation (that is upto 12 weeks of treatment for moderate to severe manic episodes in biploar 1 disorder in adolescents aged 13 and older). Prescribing responsibility to remain with HPFT CAMHS for this indication.
|Benperidol||250microgram tablets||For use in management of inappropriate sexual behaviour.|
|Chlorpromazine hydrochloride||25mg, 50mg and 100mg tablets
25mg/5ml and 100mg/5ml oral solution
|Can cause skin photosensitivity.
Oral solution to be handled with care - risk of contact sensitisation.
|Clozapine (Denzapine®)||50mg and 100mg tablets only
50mg/ml oral suspension
|Prescribing to remain within HPFT.
See Clozapine Policy and Clozapine - Key points for GPs. Suspension can settle on standing - risk of uneven distribution of clozapine and inaccurate dosing if bottle is not shaken thoroughly before dispensing/administration. Only to be used in those with swallowing difficulties or when there is poor compliance with tablets. Once service user is stabilised then consider switching to tablets.
|Flupentixol dihydrochloride||3mg tablets||See section 4.2.2 for use in depression.|
1.5mg, 5mg, 10mg, tablets
1mg/ml and 2mg/ml oral liquid
|Baseline ECG is recommended.
See DTC recommendation on haloperidol and ECG monitoring
The maximum recommended daily dose for IM and oral administration is different, because parenteral doses generally have a greater bioavailability than oral doses. See Haloperidol IM and oral equivalent doses.
Injection for HPFT prescribing only.
|Levomepromazine||25mg tablets||Use cautiously - titrate dose extremely slowly. Risk of postural hypotension in elderly, not recommended for ambulant patients over 50 years unless risk of hypotensive reaction assessed.
See Prescribing Guidelines for Acute behavioural disturbance and rapid tranquilisation (RT)
|Olanzapine||2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg tablets
5mg, 10mg, 15mg, 20mg orodispersible tablets
5mg/ml (10mg vial) injection
|Orodispersible tablets are bioequivalent to plain tablets with a similar rate and extent of absorption. They are restricted for use in those unable to swallow solid dose forms or problems with concordance.
There are slight variations in the speed at which generic orodispersible tablets dissolve in the mouth. It may be necessary to prescribe Velotab brand if there is a problem with a service user removing tablet from mouth. Velotabs are difficult to remove once placed inside the mouth but are significantly more costly than generic tablets or orodispersible tablets.
Injection for HPFT prescribing only.
|Promazine hydrochloride||25mg and 50mg tablets
25mg/5ml and 50mg/5ml oral solution
Considered less suitable for prescribing by BNF
|Quetiapine||25mg, 100mg,150mg, 200mg, 300mg tablets
50mg, 150mg, 200mg, 300mg, 400mg modified release tablets
Modified release (MR/XL) tablets are significantly more expensive than immediate release (IR) tablets.
|Risperidone||500micrograms, 1mg, 2mg, 3mg, 4mg tablets
500micrograms, 1mg, 2mg, 3mg, 4mg orodispersible tablets
1mg/ml oral liquid
|6mg strength tablets NOT APPROVED as significantly more expensive than using 2 x 3mg tablets
Orodispersible tablets restricted to those unable to swallow solid dose forms or problems with concordance.
Oral liquid should only be used when orodispersible tablets are not suitable.
|Sulpiride||200mg and 400mg tablets
200mg/5ml oral solution
|Trifluoperazine||1mg and 5mg tablets
1mg/5ml and 5mg/5ml oral solution
|Note - two different strengths of liquid available - prescribe correct strength.|
|Zuclopenthixol acetate (Clopixol Acuphase®)||50mg/ml injection and 100mg/2ml injection||Only for HPFT. NOT for primary care prescribing.
Not suitable for use in rapid tranquillisation.
DO NOT confuse with zuclopenthixol decanoate (Clopixol®) depot injection.
|Zuclopenthixol dihydrochloride||2mg and 10mg and 25mg tablets|