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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

04.03.03 Selective serotonin re-uptake inhibitors

Citalopram

Formulary

10mg, 20mg & 40mg Tablets
40mg/1mL Sugar-Free Oral Drops

Bioavailability of the oral drops is different to the tablets
8mg oral drops = 10mg tablet

Max 20mg in elderly patients due risk of QT prolongation - see MHRA warning below

 

Green Off-label use in line with Primary Care Guidelines for the Management of Chronic Non-Cancer Pain in Adults

Escitalopram

Formulary

5mg, 10mg & 20mg Tablets
20mg/1mL Sugar-Free Oral Drops

Max 10mg in elderly patients due risk of QT prolongation - see MHRA warning below

Fluoxetine

Formulary

20mg Capsules
20mg/5mL Oral Liquid

Green Off-label use in line with Primary Care Guidelines for the Management of Chronic Non-Cancer Pain in Adults

Fluvoxamine Maleate (Fluvoxamine®)

Restricted Drug Restricted

For specialist initiation or on the advice of a Mental Health Specialist

Paroxetine

Formulary

Off-label use in line with Primary Care Guidelines for the Management of Chronic Non-Cancer Pain in Adults

Seroxat 20mg/10mL oral suspension will be discontinued from October 2022.

Seroxat® 20mg tablets will be discontinued in the UK from March 2025, Seroxat® 30mg from May 2025 and Seroxat® 10mg from November 2025 for commercial reasons.

Entry reviewed: January 2025

Paroxetine
(Mental Health)

Formulary

For specialist initiation or on the advice of a Mental Health Specialist

 

Seroxat 20mg/10mL oral suspension will be discontinued from October 2022.

Seroxat® 20mg tablets will be discontinued in the UK from March 2025, Seroxat® 30mg from May 2025 and Seroxat® 10mg from November 2025 for commercial reasons.

Entry reviewed: January 2025

Sertraline

Formulary

50mg & 100mg tablets 

Off-label use in line with Primary Care Guidelines for the Management of Chronic Non-Cancer Pain in Adults

Updated August 2024

Non formulary items

Sertraline

DNP
Non Formulary

25mg, 150mg and 200mg Tablets

Updated August 2024

 

Classifications
May be initiated in any care setting
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to 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).
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.