BNF for Children 2011-2012

176 4.2.1 Antipsychotic drugs BNFC 2011–20124 Central nervous systemPericyazine (Non-proprietary) ATablets, yellow, scored, pericyazine 2.5 mg, net price84-tab pack = £9.23; 10 mg, 84-tab pack = £24.95.Label: 2Syrup, brown, pericyazine 10 mg/5 mL, net price 100-mL pack = £12.08. Label: 2PERPHENAZINECautions see notes above; hypothyroidismContra-indications see notes aboveHepatic impairment see notes aboveRenal impairment see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; less sedating; extrapyramidalsymptoms, especially dystonia, more frequent,particularly at high dosage; rarely systemiclupus erythematosusIndication and doseSchizophrenia and other psychoses, mania,short-term adjunctive management of anxiety,severe psychomotor agitation, excitement,violent or dangerously impulsive behaviour(under specialist supervision). By mouthChild 14–18 years initially 4 mg 3 times dailyadjusted according to the response; max. 24 mgdailyFentazin c (Goldshield) ATablets, both s/c, perphenazine 2 mg, net price 100-tab pack = £22.38; 4 mg, 100-tab pack = £26.34.Label: 2PIMOZIDECautions see notes aboveECG monitoring Following reports of sudden unexplaineddeath, an ECG is recommended before treatment. It is alsorecommended that patients taking pimozide should have anannual ECG (if the QT interval is prolonged, treatmentshould be reviewed and either withdrawn or dose reducedunder close supervision) and that pimozide should not begiven with other antipsychotic drugs (including depot preparations),tricyclic antidepressants or other drugs whichprolong the QT interval, such as certain antimalarials, antiarrhythmicdrugs and certain antihistamines and should notbe given with drugs which cause electrolyte disturbances(especially diuretics)Contra-indications see notes above; history ofarrhythmias or congenital QT prolongationHepatic impairment see notes aboveRenal impairment see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; less sedating; seriousarrhythmias, venous thromboembolism, glycosuria,and rarely, hyponatraemia reportedLicensed use not licensed for use in TourettesyndromeIndication and doseSchizophrenia (under specialist supervision). By mouthChild 12–18 years initially 1 mg daily, increasedaccording to response in steps of 2–4 mg at intervalsof not less than 1 week; usual dose range 2–20 mg dailyTourette syndrome (under specialist supervision). By mouthChild 2–12 years 1–4 mg dailyChild 12–18 years 2–10 mg dailyOrap c (Janssen) ATablets, scored, green, pimozide 4 mg, net price 100-tab pack = £26.87. Label: 2SULPIRIDECautions see notes above; also excited, agitated, oraggressive children (even low doses may aggravatesymptoms)Contra-indications see notes aboveHepatic impairment see notes aboveRenal impairment see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; also hepatitis andvenous thromboembolismLicensed use not licensed for use in TourettesyndromeIndication and doseSchizophrenia (under specialist supervision). By mouthChild 14–18 years 200–400 mg twice daily; max.800 mg daily in predominantly negative symptoms,dose increased to max. 2.4 g daily in mainlypositive symptomsTourette syndrome (under specialist supervision). By mouthChild 2–12 years 50–400 mg twice dailyChild 12–18 years 100–400 mg twice dailySulpiride (Non-proprietary) ATablets, sulpiride 200 mg, net price 30-tab pack =£8.09; 56-tab pack = £6.46; 400 mg, 30-tab pack =£18.57. Label: 2Dolmatil c (Sanofi-Aventis) ATablets, both scored, sulpiride 200 mg, net price 100-tab pack = £13.31; 400 mg (f/c), 100-tab pack =£34.87. Label: 2Sulpor c (Rosemont) AOral solution, sugar-free, lemon- and aniseed-flavoured,sulpiride 200 mg/5 mL, net price 150 mL =£25.38. Label: 2TRIFLUOPERAZINECautions see notes aboveContra-indications see notes aboveHepatic impairment see notes aboveRenal impairment see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; extrapyramidal symptomsmore frequent, especially at doses exceeding6 mg daily; anorexia; muscle weakness