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 |