Medicine Recommendations

Schizophrenia (not first line)

The colour classification was determined as part of the collaborative work between LCFT and medicines Management leads. Local pathways and patient safety were taken into consideration.

Narcolepsy with cataplexy

Unlicensed as a mood stabiliser

The colour classification was determined as part of the collaborative work between LCFT and medicines Management leads. Local pathways and patient safety were taken into consideration.

National Patient Safety Alert:  Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients

Treating excessive daytime sleepiness caused by narcolepsy (NICE TA758)

NICE TA 758 - Solriamfetol for treating excessive daytime sleepiness caused by narcolepsy

Adjunctive therapy of refractory generalised tonic-clonic seizures in patients with severe myoclonic epilepsy in infancy (Dravet syndrome) in combination with clobazam and valproate (under expert supervision)

Cluster Headache

Treatment of neuropathic pain in palliative care

Chronic severe pain in adults

Pain in the non-palliative care setting

Tolcapone as an adjunct to co-beneldopa or co-careldopa in Parkinson's disease with 'end-of-dose' motor fluctuations if another inhibitor of peripheral catechol-O-methyltransferase is inappropriate

Migraine prophylaxis

Please note: The MHRA has stated that topiramate is now contraindicated in pregnancy and in women of childbearing potential unless the conditions of a Pregnancy Prevention Programme are fulfilled.

MHRA: Topiramate (Topamax): introduction of new safety measures, including a Pregnancy Prevention Programme

Depressive illness

Depressive illness

Insomnia (short term use)

Schizophrenia and other psychoses, short term management of severe anxiety, psychomotor agitation, violent or dangerously impulsive behaviour, severe anxiety

Drug induced extrapyramidal side effects

Depressive illness

Hospital specialist initiation only for long term severe and disabling depressive illness, after trial of standard antidepressant treatment and as an adjunct to other antidepressant medication

Manic episodes associated with bipolar disorder.

National Patient Safety Alert: Valproate: organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients

MHRA Drug Safety Update - Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met 

MHRA Drug Safety Update: Valproate use in men: as a precaution, men and their partners should use effective contraception

Smoking cessation (NICE TA123)

NICE TA123 - Varenicline for smoking cessation