Prescribing and the choice of medication used within the Trust is based on the individual clinical needs of our service users. Any decisions on prescribing are made in line with NICE guidance.

Medicines that do not have sufficient justification of cost effectiveness to be made routinely available are classed as non-approved for use within the Trust. Unless NICE approved, all new psychiatric medicines are classed as non-approved unless approved by the Medicines Optimisation Committee.

In cases where there is felt to be an overwhelming clinical need for a service user to receive a non-approved medicine, clinicians should contact their Clinical Director and the Trust’s Chief Pharmacist.

The British National Formulary contains information to guide clinicians in the safe and effective use of medication. Formularies produced by NHS Sheffield CCG and Sheffield Teaching Hospitals NHS Foundation Trust are also supported.

Non-approved drugs list

Drug Rationale
Agomelatine

High acquisition costs

No evidence to support a role in treatment resistance

No evidence of a unique role, many other antidepressants available 

Aripiprazole (Abilify Maintena®) Insufficient justification. Further review possible if more information becomes available
Loxapine (ADASUVE®)

High cost

Insufficient justification

Lurasidone

High costs

Other drugs available

Olanzapine Depot (ZypAdhera®)

High acquisition costs

Intensive monitoring required following each injection

Other depot formulations available

Paliperidone

High acquisition cost active metabolite of risperidone (9-hydroxyrisperidone)

Many other antipsychotics available

Quetiapine slow release (XL)

Long-term high costs (branded and generics)

Little clinical advantage in majority of cases 

Licensed indication for standard and XL formulations vary

Reboxetine - for new patients

Significant doubt about the benefit verses safety profile

Many other antidepressants available

 

Responsibility and approval: Medicines Optimisation Committee
Date prepared: February 2011
Review: Yearly (as requested in Dec 2011)

Date reviewed Comments or amendments
14/08/2013 Lisdexamfetamine, loxapine (ADASUVE®) and lurasidone added
09/12/2013 Aripiprazole (Abilify Maintena®) added
14/12/2015 Vortioxetine removed as agreed only as a third line antidepressant
18/06/2018 Lisdexamfetamine removed as agreed at MOC
15/10/2018 Venlafaxine XL removed as agreed at MOC
15/10/2018 Removal of Risperdal consta from not-non approved section

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