North East and North Cumbria
ICS Formulary
 
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4 Central nervous system
04-04 CNS stimulants and other drugs used for attention deficit hyperactivity disorder

Methylphenidate
Formulary
  • Please prescribe by brand name
  • Approved for ADHD and the treatment of narcolepsy in adult and paediatrics.
  • Approved for improving working memory and processing speed following neurocognitive damage secondary to brain injury from; a brain tumour and its associated treatment (e.g. hydrocephalus and radiotherapy) or neurotoxic chemotherapy.
    • 5mg & 10mg tablets
    • 5mg, 10mg, 20mg, 30mg and 40mg m/r capsules (Medikinet® XL)
    • 10mg, 20mg & 30mg m/r capsules (Equasym® XL)18mg, 27mg & 36mg m/r tablets (Xaggitin® XL)
        • Existing patients who are prescribed Concerta® XL should be reviewed and switched to Xaggitin® XL as appropriate
        • Xaggitin® XL is bioequivalent to Concerta® XL
Link  North of Tyne, Gateshead and North Cumbria - Methylphenidate for Narcolepsy Shared Care Guidance (March 2023)
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Attention Deficit Hyperactivity Disorder (ADHD) in Adults
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Attention Deficit Hyperactivity Disorder (ADHD) in Children and Young People
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Methylphenidate secondary to brain injury
Link  South Tyneside & Sunderland APC Shared Care Guidance - Methylphenidate, Dexamfetamine, Lisdexamfetamine and Atomoxetine for treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Adults
Link  South Tyneside & Sunderland APC Shared Care Guidance - Methylphenidate, Dexamfetamine, Lisdexamfetamine, Atomoxetine and Guanfacine for treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Children and Young People
Link  TEWV ADHD prescribing algorithm in adults
Link  TEWV ADHD prescribing algorithm in Children & Young People
Link  TEWV Methylphenidate Shared Care Guideline

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Atomoxetine
Formulary
  • 10mg, 18mg, 25mg, 40mg, 60mg, 80mg & 100mg capsules
  • 4mg/1ml oral solution - approved for patients with more complex needs e.g. younger patients and those with swallowing difficulties.

 
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Attention Deficit Hyperactivity Disorder (ADHD) in Adults
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Attention Deficit Hyperactivity Disorder (ADHD) in Children and Young People
Link  TEWV Atomoxetine Shared Care Guideline

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Dexamfetamine
Formulary
  • 5mg, 10mg and 20mg tablets
    • ADHD
    • Narcolepsy
    • Doses up to 60mg daily 

 
Link  North of Tyne, Gateshead and North Cumbria - Dexamfetamine for Narcolepsy
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Attention Deficit Hyperactivity Disorder (ADHD) in Adults
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Attention Deficit Hyperactivity Disorder (ADHD) in Children and Young People
Link  TEWV Shared Care Guidelines: Dexamfetamine

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Lisdexamfetamine
Formulary
  • 20mg, 30mg, 40mg, 50mg, 60mg & 70mg capsules
    • For third line use and specialist initiation. Should only transferred to GPs after at least three month stable symptom control
    • Approved for the treatment of ADHD in adults



 
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Attention Deficit Hyperactivity Disorder (ADHD) in Adults
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Attention Deficit Hyperactivity Disorder (ADHD) in Children and Young People
Link  TEWV Shared Care Guidelines: Lisdexamfetamine

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Modafinil
Formulary
  • Approved for:
    • treatment of patients with narcolepsy
    • treatment of idiopathic hypersomnia


 
Link  MHRA Drug Safety Update (Nov 2020): Modafinil (Provigil): increased risk of congenital malformations if used during pregnancy

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Solriamfetol  Sunosi®
Formulary
  • 75mg and 150mg tablet
    • Approved for treating excesive daytime sleepiness caused by narcolepsy in line with NICE

 

 
Link  NICE TA758: Solriamfetol for treating excessive daytime sleepiness caused by narcolepsy
Link  NICE TA777: Solriamfetol for treating excessive daytime sleepiness caused by obstructive sleep apnoea (Not Recommended)

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Pitolisant Wakix®
Formulary
  • Approved for use in patients with narcolepsy who experience psychomotor side effects with modafinil and dexamfetamine.
  • To be used in line with NTAG

 
Link  NICE TA776: Pitolisant hydrochloride for treating excessive daytime sleepiness caused by obstructive sleep apnoea (NOT RECOMMENDED BY NICE)
Link  NTAG - Treatment Appraisal Decision Summary - Pitolisant (Wakix®) for the treatment of narcolepsy with or without cataplexy in adults.
Link  NTAG - Pitolisant for Narcolepsy Treatment Pathway

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Guanfacine Intuniv®
Formulary
  • 1mg, 2mg, 3mg & 4mg prolonged release tablets
    • Approved for use in children and adolescents when 1st line stimulants and atomoxetine are contraindicated or ineffective.
    • Can also be prescribed in primary care by GPs in adults who started treatment in childhood and wish to continue, for whom stimulants are not suitable, not tolerated or have been shown to be ineffective under specialist supervision

 
Link  Methylphenidate, Dexamfetamine, Lisdexamfetamine and Atomoxetine for treatment of Attention Deficit Hyperactivity Disorder (ADHD) in Adults
Link  TEWV ADHD prescribing algorithm in adults
Link  TEWV Guanfacine Shared Care Guideline

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