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BNSSG Adult Joint Formulary

16.4 Anxiety, depression and confusion- Palliative Care

Last edited: 22-05-2025

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

This section does not include terminal agitation. For agitation in the last days of life, see chapter 16.6

 

Insomnia 

See chapter 4.7 for formulary options

 

Severe anxiety

Diazepam (TLS Green)

Lorazepam (TLS Green)

  • For panic attacks

 

Depression

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

Sertraline (TLS Green)

Citalopram (TLS Green)

Mirtazapine (TLS Blue)

 

Delirium and Agitation

Ensure reversible causes have been investigated and appropriately treated

Haloperidol (TLS Green)

  • If paranoid features

Lorazepam (TLS Green)

  • Tablets and injection
  • If distress is predominant

Quetiapine (TLS Amber Specialist Recommended)

Olanzapine (TLS Amber Specialist Recommended)

Risperidone (TLS Amber Specialist Recommended)

Levomepromazine (oral) (TLS Amber Specialist Recommended)

 

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