Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
4. Central nervous system

4.3. Antidepressant drugs

4.3.1. Tricyclic and related antidepressant drugs

Total Formulary
LOFEPRAMINE
TRAZODONE
IMIPRAMINE
Specialist and GP
CLOMIPRAMINE

Restrictions: Restricted to specialist initiation only.

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AMITRIPTYLINE

4.3.2. Monoamine-oxidase inhibitors

Total Formulary
MOCLOBEMIDE

Restrictions: Restricted to patients who have failed to respond to first line antidepressants.

BNF Link

Specialist and GP
TRANYLCYPROMINE

Restrictions: Restricted to specialist initiation only. Restricted to patients who have failed to respond to first line antidepressants.

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PHENELZINE

Restrictions: Restricted to patients who have failed to respond to first line antidepressants.

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4.3.3. Selective serotonin re-uptake inhibitors

Preferred List
SERTRALINE
CITALOPRAM
FLUOXETINE

Prescribing Notes:

Fluoxetine 20mg capsules are the preferred presentation in NHSGGC. Other strengths (e.g. 10mg, 60mg capsules) should not be prescribed routinely.

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Total Formulary
PAROXETINE

4.3.4. Other antidepressant drugs

Preferred List
MIRTAZAPINE

Restrictions: Restricted to second line therapy.

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Total Formulary
VENLAFAXINE

Restrictions: The immediate release preparation is restricted to use as third line agent for depression. The MR preparation is restricted to initiation on the advice of a consultant only. The CSM have advised that venlafaxine should not be used in children and adolescents under 18 years of age. The treatment of moderate to severe generalised social anxiety disorder/social phobia has not been accepted for use by SMC and is non-Formulary.

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Specialist and GP
DULOXETINE

Restrictions: Restricted to psychiatrist initiation only as a third line therapy for major depressive episodes. The SMC has not recommended its use for generalised anxiety disorders.

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