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 Formulary Chapter 4: Central nervous system - Full Chapter
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04.04  Expand sub section  CNS stimulants and other drugs used for attention deficit hyperactivity disorder
Methylphenidate
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Restricted Drug Restricted
Amber SCA
Specialist paediatric initiation only.
Prescribe methylphenidate modified release by brand; different brands have specific release characteristics which may be tailored to individual patient circumstances (Equasym XL, Medikinet XL, Concerta XL).
Methylphenidate immediate release preparations are interchangeable and can be prescribed generically.  
Atomoxetine
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Restricted Drug Restricted
Amber SCA
Specialist paediatric initiation only. 
   
Dexamfetamine
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Restricted Drug Restricted
Amber SCA
Specialist paediatric initiation only. 
   
Lisdexamfetamine mesilate
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Restricted Drug Restricted
Amber SCA
Lisdexamfetamine is a Schedule 2 controlled drug
For ADHD refractory to methyphenidate. Specialist initiation only.
May also be used as an alternative to a "specials" preparation in patients unable to swallow solid dosage forms. (Off-label use if not refractory to methylphenidate)
The capsule can be opened and the entire contents dissolved in a glass of water. See SPC for further detail

 
   
Guanfacine
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Restricted Drug Restricted
Amber SCA
Specialist paediatric initiation only 
Link  SCA: ADHD in Children and Adolescents
   
Modafinil (Provigil)
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Restricted Drug Restricted
Amber SCA
For treatment of narcolepsy only. Restricted to initiation by Specialist at Sleep Clinic  
Link  MHRA advice: Modafinil restriction to narcolepsy
Link  SCA: Modafinil for narcolepsy
   
Pitolisant (Wakix®)
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Restricted Drug Restricted
Amber Simple

For treatment of narcolepsy.

Restricted to initiation by Specialist at Sleep Clinic.

 
   
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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
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
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

Black

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   

Red

Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).  

Amber SCA

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.   

Amber Simple

Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.  

Green Conditional

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.   

Green

Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.   

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