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BNSSG Adult Joint Formulary

16.4 Anxiety, depression and confusion- Palliative Care

Last edited: 01-02-2024

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

Severe anxiety

Recommended: (TLS Green)

Diazepam

Lorazepam

  • For panic attacks

Alternatives: (TLS Blue)

Midazolam

  • Buccal and SC (including 5mg/mL strength ampoules)

 

Depression

Once full assessment and appropriate psychological support has been addressed, consider trial of antidepressant medication

Recommended: (TLS Green)

Sertraline

Citalopram

Alternatives: (TLS Blue)

Mirtazapine

 

Delirium and Agitation

Ensure reversible causes have been investigated and appropriately treated

Recommended: (TLS Green)

Haloperidol

  • If paranoid features

Lorazepam

  • Tablets and injection
  • If distress is predominant

On advice of liaison psychiatry:

Quetiapine

Olanzapine

Risperidone

 

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