For new onset psychosis seek specialist psychiatric advice
If the therapeutic goal is calming then a benzodiazepine may be more appropriate. These should only be prescribed for short periods.
If there is an ongoing requirement for antipsychotics seek specialist advice.
ECG monitoring is required before initiation of many antipsychotic drugs. Check SPC before prescribing
Patients on atypical antipsychotics should be monitored in line with the Leicestershire Partnership Trust Guidance on the monitoring of metabolic parameters in patients prescribed regular antipsychotics and agreed shared care agreement for prescribing of atypical antipsychotics.
Schizophrenia in adults aged 18 years and over.
For those who do not respond to or do not tolerate aripiprazole, or those who are not suitable for clozapine.
For use on the advice of a specialist in psychiatry. Also licensed for treatment of mania.
Long-term safety and tolerability of olanzapine:
Following long-term (>24 weeks) treatment with olanzapine, the types of metabolic changes seen in young people aged 12−18 years are similar to those seen in adults. However, the magnitude of changes in parameters such as body weight and some blood lipid levels appears to be greater in young people
Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety.
All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry
Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).
Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.
Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.
Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.
Drugs not yet reviewed
Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence. See comments under individual entries