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Table 30Relevant interventions included in current NICE guidelines and current licence status of medication

Intervention type/useNameUK licence (only relevant indications listed)Reviewed by existing NICE guideline
MEDICATION
Alcohol dependenceAcamprosate calciumMaintenance of abstinence alcohol dependence in (it should be combined with counselling)Alcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
Alcohol deterrent compoundsDisulfiramAdjunct in the treatment of carefully selected and co-operative service users with drinking problems (15+); its use must be accompanied by appropriate supportive treatmentAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
Alpha-adrenergic agonistsClonidineHypertension; migraine (13+)Drug Misuse: Opioid Detoxification (NCCMH, 2008a)
Alpha-adrenergic agonistsLofexidineManagement of symptoms of opioid withdrawal (18+)Drug Misuse: Opioid Detoxification (NCCMH, 2008a)
Antiepileptic drugsPhenytoinAll forms of epilepsy except absence seizures; status epilepticusAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
Antiepileptic drugsTopiramateGeneralised tonic-clonic seizures or partial seizuresAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
Antimanic drugsLithiumBipolar disorder (12+)Bipolar Disorder (NCCMH, 2006)
Antimanic drugsValproic acidManic episodes associated with bipolar disorder (18+); treatment of generalised, partial or other epilepsy; no mention of manic episodesBipolar Disorder (NCCMH, 2006)
Antimanic drugs/anxiolyticsBenzodiazepine: diazepamAdjunct in acute alcohol withdrawal; short-term use in anxiety or insomniaBipolar Disorder (NCCMH, 2006)/Alcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
Antimanic drugs/anxiolyticsBenzodiazepine: lorazepamShort-term use in anxiety or insomnia, acute excitement and acute maniaBipolar Disorder (NCCMH, 2006)
Antimanic drugs/hypnoticsBenzodiazepine: chlordiazepoxideAdjunct in acute alcohol withdrawal; short-term treatment of severe anxiety that is severe with or without insomnia/short-term psychosomatic/organic or psychotic illnessAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
Antimanic drugs/hypnoticsChlormethiazoleAlcohol withdrawalAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
Antimanic/control of epilepsyCarbamazepineProphylaxis of bipolar disorder unresponsive to lithiumBipolar Disorder (NCCMH, 2006)
Antipsychotic drugs (first-generation)For example: chlorpromazine, haloperidolSchizophrenia; maniaBipolar Disorder (NCCMH, 2006)/Schizophrenia (NCCMH, 2010)
Antipsychotic drugs (second-generation)For example: clozapine, olanzapine risperidone quetiapineSchizophrenia; some individual drugs also indicated for mania. Note, clozapine only indicated for schizophrenia in people unresponsive to, or intolerant of, first-generation antipsychotic drugsBipolar Disorder (NCCMH, 2006)/Schizophrenia (NCCMH, 2010)
Opioid agonists and partial agonistsBuprenorphineTreatment for opioid drug dependence (Subutex) (16+)Drug Misuse: Opioid Detoxification (NCCMH, 2008a)
Opioid agonists and partial agonistsMethadoneTreatment of opioid drug addictions (15+)Drug Misuse: Opioid Detoxification (NCCMH, 2008a)
Opioid antagonistsNalmefeneUnlicensedAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)/Drug Misuse: Opioid Detoxification (NCCMH, 2008a)
Opioid antagonistsNaltrexoneAdjunctive prophylactic therapy in the maintenance of detoxified formerly opioid dependent service users (18+)Alcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)/Drug Misuse: Opioid Detoxification (NCCMH, 2008a)
Serotogenic agentsOndansetronPrevention and treatment of post-operative nausea and vomitingAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
Serotogenic agentsSelective serotonin reuptake inhibitors (SSRIs)DepressionAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)/Depression (NCCMH, 2010)
Skeletal muscle relaxantsBaclofenChronic severe spasticityAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
PHYSICAL AND COMPLEMENTARY INTERVENTIONS
PhysicalAcupunctureDrug Misuse: Opioid Detoxification (NCCMH, 2008a)
PhysicalElectrical transcranial stimulationAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
ComplementaryKudzu rootAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)
ComplementaryVipassana meditationAlcohol-use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence (NCCMH, 2011)

From: 8, PHARMACOLOGICAL AND PHYSICAL INTERVENTIONS

Cover of Psychosis with Coexisting Substance Misuse
Psychosis with Coexisting Substance Misuse: Assessment and Management in Adults and Young People.
NICE Clinical Guidelines, No. 120.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2011.
Copyright © 2011, The British Psychological Society & The Royal College of Psychiatrists.

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