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4.2.2 Antipsychotic depot injections

First Line
Second Line
Specialist
Hospital Only

Depixol

(Flupentixol decanoate)

  • Solution for injection 20mg/ml (£1.52 = 2ml ampoule)
  • Conc solution for injection 100mg/ml (£6.25 = 1ml ampoule)
  • Low Volume injection 200mg/ml (£19.52 = 1ml ampoule)

Indications

Notes

  1. Please prescribe by brand to avoid confusion
  2. For patients under the care of Devon Partnership NHS Trust, refer to individual shared care guidelines. For patients under the care of Livewell Southwest, prescribing and monitoring remains with the trust

Haldol Decanoate

(Haloperidol decanoate)

  • Solution for injection 50mg/1ml (£3.81 = 1ml ampoule)
  • Solution for injection 100mg/1ml (£5.05 = 1ml ampoule)

Indications

Notes

  1. For patients under the care of Devon Partnership NHS Trust, refer to individual shared care guidelines. For patients under the care of Livewell Southwest, prescribing and monitoring remains with the trust

Clopixol

(Zuclopenthixol decanoate)

  • Solution for injection 200mg/1ml (£3.15 = 1ml ampoule)
  • Conc solution for injection 500mg/1ml (£7.44 = 1ml ampoule)

Indications

Notes

  1. Please prescribe by brand to avoid confusion, ensure the correct strength and formulation is stated on the prescription to avoid errors
  2. For patients under the care of Devon Partnership NHS Trust, refer to individual shared care guidelines. For patients under the care of Livewell Southwest, prescribing and monitoring remains with the trust
Abilify Maintena

(Aripiprazole)

  • Powder and solvent for prolonged-release suspension for injection pre-filled syringes 400mg
  • Powder and solvent for prolonged-release suspension for injection vials 400mg
  • Prolonged-release suspension for injection pre-filled syringes 720mg/2.4ml, 960mg/3.2ml

Indications

Notes

  1. The commissioning of aripiprazole long-acting (depot) injection is accepted in Devon for the treatment of patients with schizophrenia who are non-adherent to antipsychotic medication or first generation antipsychotic depot injections are not clinically appropriate (see Commissioning Policy for more details).
  2. MHRA Drug Safety Update (December 2023): Aripiprazole (Abilify and generic brands): risk of pathological gambling
    1. Yellow Card reports of gambling disorder and pathological gambling associated with aripiprazole use have increased in number. The reports occurred in patients with and without a prior history of gambling disorder and the majority were reported to resolve upon reduction of dose or stopping treatment with aripiprazole. 
    2. Advise patients and their caregivers to be alert to the development of new or increased urges to gamble and other impulse control symptoms, such as excessive eating or spending, or an abnormally high sex drive.
    3. Consider dose reduction or stopping the medication if a patient develops these symptoms.
    4. Refer to the safety update for advice for patients, parents, and carers.
Zypadhera

(Olanzapine embonate monohydrate)

  • Prolonged-release injection 210mg, 300mg, 405mg

Indications

Notes

  1. Olanzapine long-acting injection is associated with post-injection syndrome. Olanzapine should only be given in health-care facilities where administration of the injection and observation of patients post-injection can be undertaken safely and for at least three hours. The three-hour observation period should be extended as clinically appropriate for patients who exhibit any signs or symptoms consistent with olanzapine overdose. Olanzapine should only be administered by healthcare professionals trained in the appropriate injection technique. Training materials are available at: https://www.zypadhera.co.uk/SignIn.aspx
  2. The commissioning of olanzapine long-acting (depot) injection is accepted in Devon for the treatment of patients with schizophrenia who are non-adherent to antipsychotic medication or first generation antipsychotic depot injections are not clinically appropriate (see Commissioning Policy for more details)
Xeplion

(Paliperidone palmitate)

  • 1-monthly prolonged-release injection available as pre-filled syringe: 50mg/0.5ml, 75mg/0.75ml, 100mg/1ml, 150mg/1.5ml

Indications

Notes

  1. Please prescribe by brand to avoid confusion
  2. The commissioning of paliperidone long-acting (depot) injection is accepted in Devon for the treatment of patients with schizophrenia who are non-adherent to antipsychotic medication or first generation antipsychotic depot injections are not clinically appropriate (see Commissioning Policy for more details)
Trevicta

(Paliperidone palmitate)

  • 3-monthly prolonged-release injection available as pre-filled syringe: 175mg/0.875ml, 263mg/1.315ml, 350mg/1.75ml, 525mg/2.625ml

Indications

Notes

  1. Please prescribe by brand to avoid confusion
  2. The commissioning of paliperidone long-acting (depot) injection is accepted in Devon for the treatment of patients with schizophrenia who are non-adherent to antipsychotic medication or first generation antipsychotic depot injections are not clinically appropriate (see Commissioning Policy for more details)
Byannli

(Paliperidone palmitate)

  • 6-monthly prolonged-release injection available as pre-filled syringe: 700mg/3.5ml, 1000mg/5ml

Indications

Notes

  1. Please prescribe by brand to avoid confusion
  2. The commissioning of paliperidone long-acting (depot) injection is accepted in Devon for the treatment of patients with schizophrenia who are non-adherent to antipsychotic medication or first generation antipsychotic depot injections are not clinically appropriate (see Commissioning Policy for more details)
Clopixol Acuphase

(Zuclopenthixol acetate)

  • Solution for injection ampoules 50mg/1ml

Notes

  1. Please prescribe by brand to avoid confusion, ensure the correct strength and formulation is stated on the prescription to avoid errors
  2. Only to be prescribed and administered in an in-patient setting in accordance with locally agreed guidelines