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Ipswich and East Suffolk CCG
North East Essex CCG
East Suffolk and North East Essex NHS Foundation Trust
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 Formulary Chapter 4: Central nervous system - Full Chapter
Notes:

Joint guidance

NSFT formulary

Please click here for the NSFT formulary

Please note while the Ipswich and East Suffolk Joint formulary mirrors what is noted in the NSFT formulary, Netformulary contains information on other indications where antipsychotics may be used e.g levomepromazine in palliative care

North East Essex CCG

Please click here for the EPUTmental health formulary for use within North East Essex CCG. Note guidance above re: other indications.

 Details...
04.03.01  Expand sub section  Tricyclic and related antidepressant drugs
04.03.01  Expand sub section  Tricyclic antidepressants
Amitriptyline (tabs, liquid)
(antidepressant)
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Formulary
Blue

Not reccomended for depression

First line for neuropathic pain

If liquid needed use 50mg/ml (lowest cost)

 
   
Imipramine (tabs, liquid)
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Formulary
Blue

Liquid is high cost

Maybe used as an alternative to trimipramine

For neuropathic pain if intolerant to amitriptyline

 
   
Clomipramine (caps)
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Restricted Drug Restricted
Green

Clomipramine is a rarely prescribed and specialist treatment. It would not be initiated within the acute hospitals at Ipswich and Colchester but existing patients admitted to the organisation would have their treatment continued; and supplies procured accordingly if necessary.

 
   
Lofepramine (tabs, liquid)
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Restricted Drug Restricted
Green

Lofepramine is a rarely prescribed and specialist treatment. It would not be initiated within the acute hospitals at Ipswich and Colchester but existing patients admitted to the organisation would have their treatment continued; and supplies procured accordingly if necessary.

 
   
04.03.01  Expand sub section  Related antidepressants
 ....
 Non Formulary Items
Amitriptyline and perphenazine  (Triptafen)

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Non Formulary
 
Amitriptyline and perphenazine  (Triptafen-M)

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Non Formulary
 
Dosulepin

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Non Formulary

Primary care guidance

Low Clinical Value Medicine

Dosulepin is captured as a "Medicine of Limited Clinical Value" by NHS England and its routine use is not recommended.

Dosulepin treatment would not be initiated within the acute Trust 

 
Doxepin

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Non Formulary

Doxepin is a rarely prescribed and specialist treatment. It would not be initiated within the acute hospitals at Ipswich and Colchester but existing patients admitted to the organisation would have their treatment continued; and supplies procured accordingly if necessary.

 
Nortriptyline  (tabs)
(depression)

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Non Formulary

Nortriptyline is a very rarely prescribed treatment within Mental Health. It would not be initiated within the acute hospitals at Ipswich and Colchester but existing patients admitted to the organisation would have their treatment continued; and supplies procured accordingly if necessary.

 
Trimipramine

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Non Formulary

Primary care guidance

Low Clinical Value Medicine

Trimipramine is captured as a "Medicine of Limited Clinical Value" by NHS England and is also very expensive.

Trimipramine treatment would not be initiated and imipramine or sertraline could be used as possible alternatives.

See guidance below for more information

Link  Switching trimipramine
 
  
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

Blue

For routine prescribing in primary and secondary care.   

Green

Initiated (if clinically urgent) or advised (if non-urgent) by specialist in secondary care, prescribing can be continued in primary care.   

Amber

Shared care  

Red Hospital

Hospital only  

Double Red

There should be no prescribing of these drugs  

Mixed

The traffic light of the drug is dependant on the indication. Please see individual drug entry for details  

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