Bnf Section 4 (Central Nervous System)

Front 1

NITRAZEPAM

Back 1

Benzodiazepine hypnotics
Insomnia
5-10mg MAX

Front 2

FLURAZEPAM

Back 2

Benzodiazepine hypnotics
Insomnia
15-30mg MAX

Front 3

LOPRAZOLAM

Back 3

Benzodiazepine hypnotics
Insomnia
1-2mg MAX

Front 4

LORMETAZEPAM

Back 4

Benzodiazepine hypnotics
Insomnia
0.5-1.5mgMAX

Front 5

TEMAZEPAM

Back 5

Benzodiazepine hypnotics
Insomnia
10-20mg (usual max) 40mg MAX in extreme cases.

Front 6

ZALEPLON

Back 6

Non-benzodiazepine hypnotics (but they act at the benzodiazepine receptor).
Insomnia
5-10mg MAX

Front 7

ZOLPIDEM TARTRATE

Back 7

Non-benzodiazepine hypnotics (but they act at the benzodiazepine receptor).
5-10mg MAX

Front 8

ZOPICLONE

Back 8

Non-benzodiazepine hypnotics (but they act at the benzodiazepine receptor).
3.75mg-7.5 MAX

Front 9

CHLORAL HYDRATE

Back 9

Hypnotics (limited role)
Insomnia
MAX - many forms - one for the BNF.

Front 10

TRICLOFOS SODIUM

Back 10

Hypnotics (limited role)
Insomnia
MAX - many forms - one for the BNF.

Front 11

CLOMETHIAZOLE

Back 11

Hypnotics (limited role)
Severe Insomnia, alcohol dependence
MAX - many forms - one for the BNF.

Front 12

PROMETHAZINE
HYDROCHLORIDE

Back 12

Antihistamines
Night Sedation and Insomnia
25mg (child max) 50mg MAX

Front 13

MELATONIN

Back 13

Pineal hormone
Insomnia
2mg MAX

Front 14

SODIUM OXYBATE

Back 14

Central nervous system depressant
Narcolepsy with cataplexy
9g daily MAX (divided doses)

Front 15

DIAZEPAM

Back 15

Benzodiazepine anxiolytics
Anxiety, insomnia, febrile convulsions, muscle spasm.
10-30mg MAX (divided doses)

Front 16

ZOLPIDEM TARTRATE

Back 16

Non-benzodiazepine hypnotics (but they act at the benzodiazepine receptor).
Insomnia
5-10mg MAX

Front 17

ZOPICLONE

Back 17

Non-benzodiazepine hypnotics (but they act at the benzodiazepine receptor).
Insomnia
3.75-7.5mg MAX

Front 18

ALPRAZOLAM

Back 18

Benzodiazepine anxiolytics
Anxiety
250-500mg x3 daily (1.5g MAX daily)

Front 19

CHLORDIAZEPOXIDE
HYDROCHLORIDE

Back 19

Benzodiazepine anxiolytics
Anxiety, adjunct in acute alcohol withdrawal.
60-100mg MAX (divided doses)

Front 20

LORAZEPAM

Back 20

Benzodiazepine anxiolytics
Anxiety, insomnia, status epilepticus.
1-4mg MAX (divided doses)

Front 21

OXAZEPAM

Back 21

Benzodiazepine anxiolytics
Anxiety, insomnia associated with anxiety
15-50mg MAX (divided or just at bedtime)

Front 22

BUSPIRONE HYDROCHLORIDE

Back 22

Anxiolytics
Anxiety (won't relieve benzo withdrawal)
15-30mg MAX (divided doses)

Front 23

MEPROBAMATE

Back 23

Anxiolytics
Anxiety
400mg (3-4 times daily)

Front 24

BARBITURATES

Back 24

Anxiolytics
Severe intractable insomnia
(avoid where possible - very dodgy dependance and withdrawal)
Not sure of the best info to add here - BNF 4.1.3 - look at the book.

Front 25

CHLORPROMAZINE
HYDROCHLORIDE

Back 25

Antipsychotics
Schizophrenia and other psychoses, mania, short-term adjunctive management of severe anxiety, psychomotor agitation, excitement, and violent or dangerously impulsive behaviour initially
Usual maintanence by mouth 75-300mg daily (MAX 1g may be required in psychosis) See BNF for additional routes

Front 26

FLUPENTIXOL
(Flupenthixol)

Back 26

Antipsychotics
Schizophrenia and other psychoses, particularly with apathy and withdrawal but not mania or psychomotor hyperactivity; depression.
3-18mg MAX

Front 27

HALOPERIDOL

Back 27

Antipsychotics
Schizophrenia and other psychoses, mania, shortterm adjunctive management of psychomotor agitation, excitement, and violent or dangerously impulsive behaviour 0.5-5mg 2-3 times daily (up to 30mg MAX - for resistent schizophrenia) Check BNF for alt routes

Front 28

LEVOMEPROMAZINE
(Methotrimeprazine)

Back 28

Antipsychotics
Schizophrenia (also palliative care)
25-50mg MAX (divided doses)
for bedpatients 100-200mg (3 divided doses up to 1g MAX)

Front 29

PERICYAZINE
(Periciazine)

Back 29

Antipsychotics
Schizophrenia and other psychoses
75-300mg MAX

Front 30

PERPHENAZINE

Back 30

Antipsychotics
Schizophrenia and other psychoses, mania, shortterm adjunctive management of anxiety, severe psychomotor agitation, excitement, and violent or dangerously impulsive behaviour
12-24mg MAX (divided doses)

Front 31

PIMOZIDE

Back 31

Antipsychotics
Schizophrenia, Monosymptomatic hypochondriacal psychosis, paranoid psychosis.
2-20mg MAX

Front 32

PROCHLORPERAZINE

Back 32

Antipsychotics
Schizophrenia and other psychoses, mania, prochlorperazine maleate or mesilate
25-100mg MAX (divided doses)

Front 33

PROMAZINE HYDROCHLORIDE

Back 33

Antipsychotics
Short-term adjunctive management of psychomotor agitation 100–200 mg 4 times daily; Agitation and restlessness in elderly, 25–50mg 4 times daily

Front 34

SULPIRIDE

Back 34

Antipsychotics
Schizophrenia
200-400mg (twice daily). 800mg MAX for predominantly negative symptoms, but 2.4g daily in mainly positive symptoms

Front 35

TRIFLUOPERAZINE

Back 35

Antipsychotics
Schizophrenia and other psychoses, short-term adjunctive management of psychomotor agitation, excitement, and violent or dangerously impulsive behaviour
5mg twice daily, increased by 5mg daily after 1 week, then at intervals of 3 days, according to the response; no MAX indicated.

Front 36

ZUCLOPENTHIXOL ACETATE

Back 36

Antipsychotics
Short-term management of acute psychosis, mania, or exacerbations of chronic psychosis.
400mg MAX per two week course of treatment (divided over the 14 days) SHORT term - long acting depot or other used for maintanence.

Front 37

ZUCLOPENTHIXOL

Back 37

Antipsychotics
schizophrenia and other psychoses
20-150mg MAX (diveded doses)

Front 38

AMISULPRIDE

Back 38

Atypical antipsychotics
Acute psychotic episode
400-800mg MAX (divided doses)

Front 39

ARIPIPRAZOLE

Back 39

Atypical antipsychotics
Schizophrenia, mania
15-30mg MAX

Front 40

CLOZAPINE

Back 40

Atypical antipsychotics
Schizophrenia (including psychosis in Parkinson’s disease) in patients unresponsive to, or intolerant of, conventional antipsychotic drugs.
12.5mg graduating up to usual daily dose 200-450mg - MAX 900mg

Front 41

OLANZAPINE

Back 41

Atypical antipsychotics
Schizophrenia, combination therapy for mania, preventing recurrence in bipolar disorder.
2.5-20mg MAX

Front 42

PALIPERIDONE

Back 42

Atypical antipsychotics
Schizophrenia
3-12mg MAX

Front 43

QUETIAPINE

Back 43

Atypical antipsychotics
Schizophrenia; treatment of episodes of mania either alone or with mood stabilisers
Usual range - Schizophrenia 300-450mg (divided doses 750mg MAX)
Mania - 400-800mg MAX

Front 44

RISPERIDONE
(tablet)

Back 44

Atypical antipsychotics
Acute and chronic psychoses, mania
Usual range 4-6mg MAX (10mg MAX for Schizophrenia if benefit is considered to outweigh the risk)

Front 45

SERTINDOLE

Back 45

Atypical antipsychotics
Schizophrenia
12-20mg (usual range) 24mg MAX

Front 46

ZOTEPINE

Back 46

Atypical antipsychotics
Schizophrenia
3 times daily 25-100mg MAX

Front 47

FLUPENTIXOL DECANOATE
(Flupenthixol Decanoate)

Back 47

Antipsychotic depot injections
Maintenance in schizophrenia and other psychoses
Usual 50mg every 4wks to 300mg every 2wks. 400mg per week MAX.

Front 48

FLUPHENAZINE DECANOATE

Back 48

Antipsychotic depot injections
Maintenance in schizophrenia and other psychoses
test dose 12.5-100mg MAX at intervals of 14-35 days.

Front 49

RISPERIDONE
(IM)

Back 49

Antipsychotic depot injections
Schizophrenia and other psychoses in patients tolerant to risperidone by mouth
12.5-50mg MAX Bi weekly

Front 50

ZUCLOPENTHIXOL DECANOATE

Back 50

Antipsychotic depot injections
Maintenance in schizophrenia and paranoid psychoses
200-500mg, 1-4 week intervals. 600mg MAX weekly

Front 51

VALPROIC ACID

Back 51

Antimanic drugs
Treatment of manic episodes associated with bipolar disorder
Usual dose divided 1-2g

Front 52

LITHIUM CARBONATE

Back 52

Antimanic drugs
Treatment and prophylaxis of mania, bipolar disorder, and recurrent depression; aggressive or self-mutilating behaviour
MAX doses
Camcolit** 250/400mg tabs 1-1.5g daily; prophylaxis, initially 300–400 mg daily
Liskonum** 450-675mg twice daily.
Priadel** 0.4–1.2 g daily as a single dose or in 2 divided doses
(Lithium carbonate 200mg equals lithium citrate 509 mg)

Front 53

LITHIUM CITRATE

Back 53

Antimanic drugs
Treatment and prophylaxis of mania, bipolar disorder, and recurrent depression; aggressive or self-mutilating behaviour
MAX doses
Li-Liquid**509mg/5ml - 1.018–3.054 g daily in 2 divided doses
Priadel**520mg/5ml 1.04–3.12g daily in 2 divided doses
(lithium citrate 509mg equals Lithium carbonate 200mg )

Front 54

AMITRIPTYLINE HYDROCHLORIDE

Back 54

Antidepressants (Tricyclic)
Depressive illness (but not recommended); neuropathic pain; migraine prophylaxis
For depression - 75-200mg MAX

Front 55

CLOMIPRAMINE HYDROCHLORIDE

Back 55

Antidepressants (Tricyclic)
Depressive illness, phobic and obsessional states; adjunctive treatment of cataplexy associated with narcolepsy
Depressive illness gradually from 10mg to 30-300mg MAX (divided doses)
Phobic and obsessional states 25-250mg MAX

Front 56

DOSULEPIN HYDROCHLORIDE
(Dothiepin hydrochloride)

Back 56

Antidepressants (Tricyclic)
Depressive illness, particularly where sedation is required.
75-150mg MAX (250mg MAX in hospital)

Front 57

DOXEPIN

Back 57

Antidepressants (Tricyclic)
Depressive illness, particularly where sedation is required
75mg daily (divided doses), single bedtime dose 30-300mg MAX.

Front 58

IMIPRAMINE HYDROCHLORIDE

Back 58

Antidepressants (Tricyclic)
Depressive illness
150–200 mg (up to 300 mg in
hospital patients)

Front 59

LOFEPRAMINE

Back 59

Antidepressants (Tricyclic)
Depressive illness
140–210 mg MAX (divided doses)

Front 60

NORTRIPTYLINE

Back 60

Antidepressants (Tricyclic)
Depressive illness
75–100mg 150mg MAX

Front 61

MIANSERIN HYDROCHLORIDE

Back 61

Antidepressants (Tricyclic related)

Front 62

TRIMIPRAMINE

Back 62

Antidepressants (Tricyclic)
Depressive illness, particularly where sedation is required.
50-300mg MAX

Front 63

TRAZODONE HYDROCHLORIDE

Back 63

Antidepressants (Tricyclic)
Depressive illness, particularly where sedation is required, anxiety
Depression 150-600mg MAX (divided doses)
Anxiety 75-300mg MAX

Front 64

PHENELZINE

Back 64

Antidepressants - (MAOIs)
Depressive illness
15-30mg MAX 3 times daily (30mg in hospital)

Front 65

ISOCARBOXAZID

Back 65

Antidepressants - (MAOIs)
Depressive illness
30-60mg MAX

Front 66

TRANYLCYPROMINE

Back 66

Antidepressants - (MAOIs)
Depressive illness
10mg x2 daily (no later than 3pm). 2nd dose up to 20mg. MAX 30mg daily - more under CLOSE supervision.

Front 67

MOCLOBEMIDE

Back 67

Antidepressants - (RIMA) Reversible MAOIs
Major depressive illness; social anxiety disorder
Depression 150-600mg MAX
Social anxiety 300-600mg MAX
(divided doses in both cases)

Front 68

CITALOPRAM

Back 68

Antidepressants (SSRIs)
Depressive illness, panic disorder
20-60mg MAX

Front 69

MAOIs

Back 69

Monoamine-oxidase inhibitors

Front 70

ESCITALOPRAM

Back 70

Antidepressants (SSRIs)
Depressive illness, generalised anxiety dissorder, and OCD
10-20mg MAX

Front 71

FLUOXETINE

Back 71

Antidepressants (SSRIs)
Major depression, bulimia nervosa, OCD
20-60mg MAX

Front 72

FLUVOXAMINE MALEATE

Back 72

Antidepressants (SSRIs)
Depressive illness, obsessive-compulsive disorder
50-300mg MAX (evening)

Front 73

PAROXETINE

Back 73

Antidepressants (SSRIs)
Major depression, obsessive-compulsive disorder, panic disorder; social anxiety disorder; posttraumatic stress disorder; generalised anxiety disorder
20-60mg MAX

Front 74

SERTRALINE

Back 74

Antidepressants (SSRIs)
Depressive illness, obsessive-compulsive disorder (under specialist supervision in children), post-traumatic stress disorder in women
50-200mg MAX

Front 75

SSRIs

Back 75

Selective serotonin re-uptake inhibitors

CITALOPRAM
ESCITALOPRAM
FLUOXETINE
FLUVOXAMINE MALEATE
PAROXETINE
SERTRALINE

Front 76

DULOXETINE

Back 76

Antidepressants - (SNRI)
major depressive disorder; generalised anxiety disorder; diabetic neuropathy
30-120mg MAX

Front 77

VENLAFAXINE

Back 77

Antidepressents - (SNRI)
Major depression, generalised anxiety disorder.
75-375mg MAX

Front 78

SNRIs

Back 78

Serotonin and noradrenaline re-uptake inhibitors

DULOXETINE
VENLAFAXINE

Front 79

MIRTAZAPINE

Back 79

Antidepressant: presynaptic alpha -adrenoreceptor antagonist, increases central noradrenergic and serotonergic neurotransmission.
Major depression
15-45mg MAX

Front 80

FLUPENTIXOL
(Flupenthixol)

Back 80

The thioxanthene flupentixol (Fluanxolc) has antidepressant properties, and low doses (1 to 3mg daily) are given by mouth for this purpose. Flupentixol is also used for the treatment of psychoses
Depressive illness; psychoses
1-3mg MAX

Front 81

REBOXETINE

Back 81

Antidepressant - a selective inhibitor of noradrenaline reuptake
Major Depression
8-12mg MAX (divided doses)

Front 82

TRYPTOPHAN

Back 82

Antidepressent - adjunctive therapy for depression resistant to standard antidepressants; it has been associated with eosinophilia-myalgia syndrome. Tryptophan should be initiated under specialist supervision.
1g (x3) up to 6g daily MAX

Front 83

Atypical antipsychotic drugs

Back 83

Amisulpride
Aripiprazole
Clozapine
Olanzapine
Paliperidone
Quetiapine
Risperidone
Zotepine

Front 84

Antipsychotics (neuroleptics) Group 1

Back 84

Chlorpromazine
Levomepromazine (methotrimeprazine)
Promazine
Generally characterised by pronounced sedative effects and moderate antimuscarinic and extrapyramidal sideeffects.

Front 85

Antipsychotics (neuroleptics) Group 2

Back 85

Pericyazine
Pipotiazine
Generally characterised by moderate sedative effects, marked antimuscarinic effects, but fewer extrapyramidal side-effects than groups 1 or 3.

Front 86

Antipsychotics (neuroleptics) Group 3

Back 86

Fluphenazine
Perphenazine
Prochlorperazine
Trifluoperazine
Generally characterised by fewer sedative effects, fewer antimuscarinic effects, but more pronounced extrapyramidal sideeffects than groups 1 and 2.