Our core purpose is to work with people and lead communities in improving their mental and physical health and wellbeing for a better life; through delivering excellent and responsive prevention, diagnosis, early intervention, treatment and care.
Welcome to our section on medicines and medication. The focus of this section is on medicines for mental health problems, but the information and links will hopefully be more widely useful.
Click on one of the buttons below to learn more. At the bottom of the page you can find information on current issues in mental health medicines availability.
We use medicines to help people get well and stay well. The same medicines can be a danger if too much or too many are taken. Click on the drop down box for more information about some of the dangers and how to keep yourself or others safe. This information can also be downloaded as a leaflet.
Healthcare professionals who are talking to patients about these risks and how to stay safe can use our guidance to help with their conversations.
Reducing the risk of overdoses with opioids, benzodiazepines, pregabalin and tricyclic antidepressants
Overdoses can involve prescribed medicines; medicines bought at a shop, pharmacy or on-line. They can involve illegal “street drugs” or alcohol. Overdoses are often accidental. The medicines or drugs might be the person’s own property or someone else’s to which they have access.
Many of the medicines we use can be dangerous in overdose. There are particular concerns about the ones mentioned here.
Opioids are natural drugs derived from the opium poppy, or artificial drugs that do the same things.
Opioids act in the brain and nervous system to block pain signals. Commonly used opioids include oxycodone, morphine, codeine, fentanyl, heroin, methadone and buprenorphine.
Benzodiazepines are drugs that cut-down overactivity of the brain and nervous system. They are often given to help with pain, help you to sleep or to feel less anxious. Commonly used benzodiazepines include diazepam (Valium), lorazepam and temazepam. Alprazolam (Xanax) is a benzodiazepine that is not used by the NHS but is increasingly of concern to drug misuse services.
Opioids and benzodiazepines reduce normal, automatic functions like breathing. If an overdose is taken, the person may stop breathing and die.
Pregabalin is a medicine for treating epilepsy, pain or anxiety. Pregablin increases the effect of opioids in reducing breathing. At higher doses it directly reduces breathing. Pregabalin seriously increases the harm caused by an opioid overdose.
Tricyclic antidepressants (TCAs) are used to treat depression, anxiety and long-term pain. Commonly used TCAs include amitriptyline, clomipramine and imipramine. In overdose TCAs can stop the heart.
The chance of overdose and the amount of harm is increased by taking:
Opioids, benzodiazepines, TCAs and pregabalin are still useful medicines when used properly and safely. There are a number of things that can be done to keep people safe.
If you don’t feel safe with your medicines, please talk to someone. Your doctor, nurse or pharmacist can help you.
Click on the drop-down boxes below for more information about each type of medication. Please also read the disclaimer at the bottom of the page.
Which medication is affected?
Olena dispersible tablets. These contain 20mg of fluoxetine per tablet and are designed to be mixed with water before taking.
(Olena is the brand name, fluoxetine is the active ingredient.)
What is the problem?
When will the problem stop?
The maker thinks that the tablets will be available from the end of November 2019. This estimate has increased from information previously given.
What else can be done?
How can I learn more?
More information about fluoxetine can be found on the Choice and Medication website.
Last updated: 19/11/2019 by Stephen Jones
Source: Department of Health and Social Care
How can I learn more?
More information about this medicine can be found on the moclobemide page on the Choice and Medication website.
More information about treating depression or social anxiety can be found on the Choice and Medication website.
Last updated: 27/01/2020 by Stephen Jones
Source: Department of Health and Social Care and subsequent information from Sandoz.
Nardil tablets. These contain 15mg of phenelzine per tablet.
(Nardil is the brand name, phenelzine is the active ingredient.)
The maker thinks that the problem will go on until March 2020 at least. This estimate has increased since the problem first happened.
More information about phenelzine can be found on the Choice and Medication website.
Source: Specialist Pharmacy Service; Department of Health and Social Care
Paroxetine 20mg in 10mL oral solution (liquid medicine)
Paroxetine is sometimes also known as Seroxat
The maker thinks that the oral solution will be available from January 2020.
More information about paroxetine can be found on the Choice and Medication website.
Source: Department of Health and Social Care
We have been informed that some makers of sulpiride tablets are no longer making them.
The tablets are still being made other companies, however the tablets are currently difficult to get hold of. There are still supplies at some wholesalers but not all. Sulpiride is still available as a liquid medicine.
The information we have been provided says that:
Last updated: 07/02/2020 by Stephen Jones
Trifluoperazine tablets in both strengths (1mg tablets and 5mg tablets).
There are no longer any brand-names for trifluoperazine. It used to have the brand name “Stelazine”.
More information about trifluoperazine can be found on the Choice and Medication website.
Last updated: 28/08/2019 by Stephen Jones
Venlafaxine tablets of 37.5mg and 75mg strengths manufactured by Teva.
More information about venlafaxine can be found on the Choice and Medication website.
Last updated: 20/12/2019 by Stephen Jones
Source: Information received from medication manufacturers
Always speak to your healthcare professional(s) to ensure that the information provided here applies to your personal circumstances.
This information is provided on the understanding that it is the best available to us at the time of writing.
The information does not endorse particular medicines and is a resource to supplement the expertise, knowledge and judgement of healthcare professionals working in partnership with patients and carers.
Children and young people's services
Learn about our services for people with a learning disability
Make an appointment
Information for members of the public and health professionals on requesting treatment and support
Learn about different ways to stay healthy and well