All Guidance

Methylphenidate, Lisdexamfetamine, Dexamfetamine, Atomoxetine - For Attention Deficit Hyperactivity Disorder in adults aged over 17 years and in children and adolescents aged 6 to 17 years

Guanfacine - For Attention Deficit Hyperactivity Disorder in children and adolescents aged 6 to 17 years 

Amisulpride, Aripiprazole, Olanzapine, Quetiapine, Oral Risperidone
This shared prescribing guideline for the second-generation antipsychotic medications listed above has been developed with due consideration to the appropriate NICE Clinical Guidelines (CG) e.g. Bipolar Disorder (CG185), Psychosis and Schizophrenia in Children and Young People (CG155), Psychosis and Schizophrenia in Adults (CG178), Schizophrenia- Aripiprazole (TA213), Bipolar Disorder- Adolescents (TA292).

Please note: Morecambe Bay CCG has now adopted this Shared-care guideline for all areas, including South Cumbria. 

Refer to Local Commissioning Policy Before Use

Treatment of Parkinson’s Disease

This guideline provides recommendations on the medical management of adults with chronic non-cancer pain.

This guidance does not apply to the use of Sativex® (delta-9-etrahydrocannabinol and cannabidiol) oromucosal spray as an adjunct treatment for moderate to severe spasticity in multiple sclerosis

To be read in conjunction with the SPC , NICE TA 217 and NICE CG42

The Lancashire Medicines Management Group does not recommend the prescribing of e-Cigarettes

Formerly the 'North West Headache Management Guideline for Adults'

To be read in conjunction with the LSCMMG guideline ‘Assessing suitability of strong opioid use’

Please note: a standard operating procedure for switching Keppra preparations to generic levetiracetam preparations is available in support of the position statement below. This is for use by practice supporting pharmacy teams across Lancashire and South Cumbria ICB ONLY

Licensed Indications

1. In the management of acute mania or hypomanic episodes
2. In the management of episodes of recurrent depressive disorders where treatment with other antidepressants has been unsuccessful
3. In the prophylaxis against bipolar affective disorders
4. Control of aggressive behaviours of intentional self-harm.

This is a summary document intended for Primary Care, taken from a more comprehensive document ‘Guidelines for the Management of Behavioural and Psychological Symptoms of Dementia (BPSD) in Primary and Secondary Care. This document should be accessed for additional resources such as the Leaflet for Care Home Staff, assessment forms and flow chart for responding to BPSD.

Information contained within this document is largely taken from the PrescQIPP toolkit ‘Reducing Antipsychotics in Dementia and documents available on the Alzheimer’s Society website.

Guidance on consensus approaches to managing Palliative Care Symptoms

To extend life or the time to mechanical ventilation for adult patients with amyotrophic lateral sclerosis (ALS) 1,2, variant of Motor Neurone Disease (MND). Safety and efficacy of riluzole has only been studied in ALS. Therefore, riluzole should not be used in patients with any other forms of MND. Riluzole should only be initiated by a neurological specialist with expertise in the management of MND (as per NICE TA 20, 2001)

It is expected that most patients will be managed by secondary care however this guideline is those patients who need to be managed in community