netFormulary

North East and North Cumbria
ICS Formulary

4 Central nervous system

04-03-04 Other antidepressant drugs

These drugs are for use in patients not responding adequately to first-line treatments.

Agomelatine

Formulary

NETAG approved for the treatment of depression only following an adequate trial of at least three alternative antidepressant drugs at maximally tolerated doses (as described by NICE and as stated in the BNF).
Prescribing and monitoring should be initiated by specialist mental health physicians.
- Transfer of prescribing to primary care at around 6 months / when LFT monitoring completed following dose increase

Bupropion Hydrochloride

Formulary

Duloxetine

Formulary

For use on advice of psychiatrists as a third-line antidepressant - but only for use in patients who cannot tolerate high-dose (>150mg daily) venlafaxine, or patients with hypertension, established CHD or other cardiovascular risk factors which would make the use of high-dose venlafaxine undesirable.
Also approved for third-line use (after drugs such as the tricyclic antidepressants and gabapentin) in the treatment of neuropathic pain on the advice of pain specialists.