4.2 Drugs used in Psychoses & related disorders
NHS IOW Choice and Medication Website
4.2.1 Antipsychotic drugs
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CHLORPROMAZINE | ||||
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FLUPENTIXOL | ||||
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HALOPERIDOL | ||||
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LEVOMEPROMAZINE | ||||
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PROMAZINE | ||||
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SULPIRIDE | ||||
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TRIFLUOPERAZINE | ||||
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ZUCLOPENTHIXOL |
Atypical antipsychotic drugs
NICE CG82 - Schizophrenia: Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care March 2009
| 1st | |
AMISULPRIDE | |||||
| 1st | |
OLANZAPINE | Olanzapine Velotab are restricted to patients with swallowing difficulties or compliance issues | ||||
| 1st | |
QUETIAPINE & XL | |||||
| 1st | |
RISPERIDONE oral | |||||
| 2nd | |
ARIPIPRAZOLE (Yellow) | |||||
| 2nd | |
LURASIDONE (Yellow) | If patient has failed on 2 alternatives and has unacceptable weight gain | ||||
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RISPERIDONE IM (Risperdal Consta) | ||||||
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ARIPIPRAZOLE Injection (Abilify Maintena) | Only for use in patients established on aripirazole but with poor oral compliance. Aripiprazole should be used when existing atypical is ineffective or not tolerated | |||||
| NICE TA292 | Bipolar disorder (adolescents) - aripiprazole | Jul 13 | |||||
| NICE TA213 | Schizophrenia - aripiprazole | Jan 11 | |||||
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CLOZAPINE | Use clozapine for treatment-resistant schizophrenia (specialist only) |
Extrapyramidal symptoms are generally less of a problem with atypical antipsychotics. Use an oral atypical antipsychotic first line for newly diagnosed schizophrenia (Risperidone or amisulpiride considered appropriate first line drugs locally)
There is little difference between atypicals in terms of efficacy (except clozapine).
Choice of atypical may also be governed by the need to avoid/reduce specific adverse affects. For the following problems:
Extrapyramidal symptoms, including secondary negative symptoms - consider quetiapine or olanzapine
Hyperprolactinaemia with others - consider quetiapine or aripiprazole
Sexual dysfunction with others - consider olanzapine, quetiapine or aripiprazole
Diabetes - consider amisulpride (caution with olanzapine, clozapine, quetiapine)
Weight gain - consider amisulpiride, sulpiride or aripiprazole
Postural hypotension - consider amisulpiride or sulpiride
Inadequate seadtion - consider quetiapine or olanzapine
4.2.2 Antipsychotic Depot Injections
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FLUPENTIXOL (Yellow) | |||||
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FLUPHENAZINE (Yellow) | |||||
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HALOPERIDOL (Yellow) | |||||
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OLANZAPINE EMBONATE Depot inj (ZypAdhera) | |||||
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PIPOTIAZINE (Yellow) | |||||
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ZUCLOPENTHIXOL (Yellow) | |||||
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PALIPERIDONE Depot inj (Xeplion) | |||||
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RISPERIDONE |
4.2.3 Antimanic Drugs
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VALPROIC ACID (DEPAKOTE) | |||||
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LITHIUM (Amber) (order by brand name) | |||||
| Lithium Prescribing Guidelines |
