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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 4 - Central nervous system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
04.02.01 Antipsychotic Drugs
NICE CG103: Delirium NICE CG178: Schizophrenia
04.02.01 First-Generation Antipsychotic Drugs
04.02.01 Second-Generation Antipsychotic Drugs
NICE CG103: Delirium NICE CG178: Schizophrenia

Amisulpride

Amber SPA
Formulary
50mg, 200mg & 400mg Tablets
100mg/1mL oral solution
BNF BNFc SPC

Aripiprazole

Amber SPA
Restricted Drug Restricted
5mg, 10mg, 15mg & 30mg Tablets
10mg & 15mg Orodispersible Tablets
1mg/1mL Solution

Restricted - to be prescribed in accordance with NICE TA213 and 292.
BNF BNFc SPC
DSU December 2023: Aripiprazole (Abilify and generic brands): risk of pathological gambling NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years NICE TA292: Bipolar disorder (children) - aripiprazole

Aripiprazole (Abilify®)
(Solution for injection)

RED
Restricted Drug Restricted

Only for continuation of treatment whist inpatient at Luton & Dunstable Hospital.
Initiation by Psychiatrist (Mental Health Trust) only, in line with NICE TA213 and 292 (as above).

Each mL contains 7.5 mg of aripiprazole. Each vial contains 9.75 mg aripiprazole (1.3mL).

BNF BNFc SPC
DSU December 2023: Aripiprazole (Abilify and generic brands): risk of pathological gambling

Risperidone

Amber SPA
Formulary

0.5mg, 1mg, 2mg, 3mg, 4mg & 6mg Tablets
0.5mg, 1mg, 2mg & 3mg Orodispersible Tablet
1mg/1mL Oral Liquid

Do not prescribe 250 microgram (0.25mg) tablets due to high cost - instead consider halving the 500 microgram tablets which are scored.

Entry reviewed: February 2025

BNF BNFc SPC

Clozapine (Clozaril®)
(Prescribe by brand name)

RED
Restricted Drug Restricted
Can only be prescribed by consultant Psychiatrist.

Supply of medication must be obtained from patient wherever possible - no stock kept at L&D Pharmacy. Must be dispensed by Mental Health Trust.

Prescriptions must include proprietary name.
BNF BNFc SPC
DSU Oct 2017: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus MHRA Drug Safety Update: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity (August 2020)

Clozapine (Denzapine®)
(Prescribe by brand name)

RED
Restricted Drug Restricted
Can only be prescribed by consultant Psychiatrist.

Supply of medication must be obtained from patient wherever possible - no stock kept at L&D Pharmacy. Must be dispensed by Mental Health Trust.

Prescriptions must include proprietary name.
BNF BNFc SPC
DSU Oct 2017: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus MHRA Drug Safety Update: Clozapine and other antipsychotics: monitoring blood concentrations for toxicity (August 2020)

Lurasidone (Latuda®)
(Tablets)

Amber SPA
Restricted Drug Restricted

Restricted use in Mental Health Trust, initiation only by specialist Mental Health Prescribers

BNF BNFc SPC

Olanzapine

Amber SPA
Formulary
2.5mg, 5mg, 7.5mg, 10mg & 20mg Tablets
5mg, 10mg, 15mg & 20mg Orodispersible Tablet

BNF BNFc SPC

Olanzapine 10mg
(Powder for Injection)

RED
Formulary

IM injection for use as per Trust guideline for Rapid Tranqulisation

BNF BNFc SPC

Paliperidone

RED
Restricted Drug Restricted

For initiation and continuation by Mental Health specialists

BNF BNFc SPC

Quetiapine
(Tablets)

Amber SPA
Formulary

25mg, 50mg, 100mg, 150mg, 200mg and 300mg tablets

Preferred formulation in primary care

BNF BNFc SPC

Quetiapine XL
(Tablets)

Amber SPA
Formulary

 

Reserved for use if patient is unable to tolerate immediate release formulation.

Current preferred brand in Primary Care is Sondate® XL

Secondary care: hospital contract brand will be provided

BNF BNFc SPC
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.