Home > Formulary : Adult > Local Guidelines >
4. Central Nervous System Guidelines
Pain
BNSSG Chronic pain and related pain conditions guidelines (adults)
BNSSG Chronic pain and related pain conditions – summary flow chart
Opioid Conversion charts (Adults) 2024
Chronic Pain Self Help Resources Summary
BNSSG Paracetamol Dosing Guidelines In Adult Patients 2023
BNSSG Reducing and Stopping Opioids, Information for Patients leaflet
BNSSG Benzodiazepine and Z-drug Prescribing (including withdrawal) Support Document
Nalmefene Prescribing Guidance
Top Tips for Prescribing Opioids In Older People Living With Frailty
BNSSG Migraine Prevention Pathway
Health Innovation West of England - Improving chronic pain management by reducing harm from opioids resources
Gabapentinoid Position Statement
Gabapentinoid information poster for clinicians
Nicotine Replacement Therapy
Nicotine Replacement Guidelines 2023
Parkinson's Disease
Community guidelines for management of Parkinson's Disease pts with swallowing difficulties 2022
Dementia
Medication to avoid prescribing in dementia for common physical health conditions
Depression
BNSSG Guideline for the Management of Depression Adults
Valproate Safety - Support resources
Valproate Roles and Responsibilities
Local Referral pathways and contact details
Valproate Shared Care protocol
Valproate Original Pack dispensing of valproate exceptions risk assessment
NHS England Shared Decision Tools for Valproate - shared decision tools have been published by NHSE for people with bipolar disorder or epilepsy.
NHS South East Clinical Delivery and Networks Valproate Easy Read Valproate Leaflet - The South East Regional Clinical Quality Improvement team have worked with clinicians and people using health services and have developed an information leaflet to support person-centred, informed discussions about how to take valproate as safely as possible. The leaflet has been translated into 30 languages.
MHRA Drug Safety Update February 2025 - Review by two specialists is required for initiating valproate but not for male patients already taking valproate. Three infographics have been produced by the MHRA to clarify in which situations review by two specialists may be required:
- for female patients under 55 years old
- for male patients under 55 years old
- for male and female patients 55 years and older
MHRA Drug Safety Update June 2025 - There are now updated safety and educational materials available to support the implementation of the regulatory measures announced in the November 2023 National Patient Safety Alert and the September 2024 Drug Safety Update. They also include previous updates to product information on the risk of low birth weight in children exposed to valproate during pregnancy.
MHRA Risk Minimisation Materials June 2025 - Patient Guide for Women
Valproate use in men
- MHRA Drug Safety Update September 2024 - as a precaution men and their partners should use effective contraception. See MHRA's:
- Advice for male patients on valproate to use contraception
- Visual risk communication diagram to be used by a healthcare professional when counselling on the risks
- GP practice SNOMED coding valproate (Males)
- GP practice text message (adult and paediatric) valproate (Males)
- Valproate Roles and Responsibilities (Male Patients)
- Valproate Q&A Resource
- Educational resource to help clinicians discuss sex / sexual health / pregnancy prevention with those that have autism and / or a learning disability and are taking valproate
- Valproate review appointment template letter for those that have autism and/ or a learning disability and are taking valproate
- MHRA Risk Minimisation Materials June 2025 - Valproate Guide for Male Patients
Topiramate Safety - Support Resources
Topiramate Update for Primary Care
Insomnia