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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
04.03.04 Other antidepressant drugs
NICE CG192: Antenatal and postnatal mental health: clinical management and service guidance NICE CG28: Depression in children and young people NICE CG53: Chronic fatigue syndrome / Myalgic encephalomyelitis NICE CG90: Depression in adults NICE CG91: Depression with a chronic physical health problem

Agomelatine (Valdoxan®)

RED
Restricted Drug Restricted

For initiation and ongoing prescribing by ELFT Specialist only.

 

Entry reviewed: June 2022

BNF BNFc SPC

Bupropion (Zyban®)
(Modified release tablet 150mg)

RED
Formulary

 Off-label use for treatment-resistent depression.

Prescribing support document is in development [Last updated October 2025]

Entry reviewed: May 2025

BNF BNFc SPC

Duloxetine 30mg, 60mg Capsules
(GAD or depression)

Amber SPA
Formulary

Specialist to advise for GAD or depression

 

NB: The 90mg and 120mg are high cost NON FORMULARY strengths.

NB: The 20mg and 40mg are only licensed for stress incontinence and are Non-Formulary for the above indications.

 

Entry reviewed: May 2023

BNF BNFc SPC

Duloxetine 30mg, 60mg Capsules
(For management of Chronic Non-Cancer Pain in Adults)

GREEN
Formulary

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

 

NB: The 90mg and 120mg are high cost NON FORMULARY strengths.

NB: The 20mg and 40mg are only licensed for stress incontinence and are Non-Formulary for the above indications.

 

Entry reviewed: May 2023

BNF BNFc SPC

Mirtazapine

GREEN
Formulary

15mg & 30mg Tablets
15mg, 30mg & 45mg Orodispersible Tablets

 

NB: Oral solution is 50x more expensive than orodispersible tablets.
Use orodispersible tablets for patients with swallowing difficulties and for enteral tube administration.

BNF BNFc SPC

Reboxetine (Edronex®)
(Tablets)

Amber SPA
Restricted Drug Restricted

For initiation by Mental Health specialist from ELFT only

 

 

BNF BNFc SPC

Venlafaxine oral
(For licensed indications)

GREEN
Formulary

37.5mg & 75mg tablets
37.5mg modified release tablets
75mg & 150mg modified release capsules

 

Entry reviewed: June 2022

 

BNF BNFc SPC

Venlafaxine oral
(for narcolepsy and cataplexy)

GREEN
Formulary

37.5mg & 75mg tablets
37.5mg modified release tablets
75mg & 150mg modified release capsules

To be used in line with EoE PAC guidance for narcolepsy and cataplexy. Refer to Shared Care Guideline associated with sleep centre attended by the patient.

 

Entry reviewed: June 2022

 

BNF BNFc SPC

Vortioxetine

Amber SPA
Restricted Drug Restricted
Restricted - only to be initiated by a Consultant Psychiatrist for treating major depressive episodes in accordance with NICE TA367.

5mg, 10mg & 20mg Film Coated Tablets
BNF BNFc SPC
NICE TA367: Vortioxetine for treating major depressive episodes

Flupentixol

Amber SPA
Formulary

500microgram, 1mg, 3mg Tablets

Entry reviewed July 2025

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.