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 Formulary Chapter 4: Central nervous system - Full Chapter
04.02.03  Expand sub section  Drugs used for mania and hypomania
 note  Anti-manic drugs should be initiated by specialist mental health services
Asenapine
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Formulary Sublingual tablets

Restricted Item Pennine Care: may be considered third line for inpatients who have failed to respond or failed to tolerate existing therapies. 
   
04.02.03  Expand sub section  Benzodiazepines
 note  Benzodiazepines may be helpful in the initial stages of treatment for behavioural disturbance or agitation. See section 4.1.
04.02.03  Expand sub section  Antipsychotic drugs
 note  Antipsychotic drugs are useful in acute episodes of mania and hypomania. See section 4.2.1.
Anti-manic drugs should be initiated by specialist mental health services.
04.02.03  Expand sub section  Carbamazepine
Carbamazepine
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Formulary
Green 3
Tablets
M/R tablets
Liquid
Suppositories
 
   
04.02.03  Expand sub section  Valproic acid to top
Valproic Acid (Depakote)
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Formulary
Green 3
Tablets 
Link  MHRA Safety Alert: Valproate and abnormal pregnancy outcomes
   
04.02.03  Expand sub section  Lithium
 note  Lithium should be prescribed by brand.
Care needed when swapping from liquid to tablets and vice versa.
Lithium Carbonate tablets (Camcolit or Priadel)
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Formulary
Amber
 
   
Lithium Citrate liquid (Li-Liquid or Priadel)
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Formulary
Amber
 
   
 ....
 Non Formulary Items
Lithium Carbonate  (Liskonum®)

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Non Formulary
 
  
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
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
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

Amber

Drugs designated amber are suitable for shared care arrangements under a shared care protocol. Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.   

Black

These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products.  

Green

Not used   

Green 1

Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

Green 2

Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required.  

Green 3

Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required.  

Grey

Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient.   

Red

Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.   

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