adverse event uncertain, nausea, diarrhoea, abdominal Continue treatment unless GP consult Summary of cramps severe Product Characteristics & or BNF Refer to Specialist Team Symptoms of depression, Continue treatment & GP paranoia, psychosis, anxiety urgently refer to Specialist Team Palpitations, tachycardia, Stop treatment & GP hypertension or hypotension Refer to Specialist Team sleep disturbances, insomnia Continue treatment & Refer GP to Specialist Team seizures, convulsions Discontinue drug immediately GP/Specialist Team Send immediately to A&E movement disorders, tics, Continue treatment unless GP tremors severe & Refer to Specialist Team anorexia, significant weight Continue treatment & Refer GP loss, growth retardation to Specialist Team The patient should be advised to report any of the following signs or symptoms to their GP without delay: Aggression, depression, paranoia, anxiety, suicidal thinking or self-harming behaviour Cardiac symptoms racing pulse, increased heart rate, chest pain – Uncontrollable muscle movements Other important co morbidities: Autistic Spectrum Disorder, Tourette syndrome, Depression, Anxiety Any adverse reaction to a black triangle drug or serious reaction to an established drug should be reported to the MHRA via the “Yellow Card” scheme. 11.Baseline List of investigations / monitoring undertaken by secondary care investigations See appendix 1 attached towards the end of this document Routine blood tests and ECGs are not recommended unless there is a clinical indication. Weight, heart rate and blood pressure should be measured on initiation by specialist. 12. Ongoing Is monitoring required? Yes (N.B. Routine blood tests and ECGs are not monitoring recommended unless there is a clinical indication) requirements to be undertaken by GP Prescribers should check local commissioning arrangements prior to implementing shared care as there may be variation in who is responsible for the physical health checks due to differences in local commissioning arrangements. Monitoring Frequency Results Action By whom Height and 6 monthly All results If abnormal refer GP Weight should be to Specialist plotted on Team centile charts BP & Pulse Before & after If abnormal refer GP each dose to Specialist change, and 6 Team monthly Life threatening changes should be referred to
adverse event uncertain, consult Summary of Product Characteristics or BNF nausea, diarrhoea, abdominal cramps Continue treatment unless severe & Refer to Specialist Team GP Symptoms of depression, paranoia, psychosis, anxiety Continue treatment & urgently refer to Specialist Team GP Palpitations, tachycardia, hypertension or hypotension Stop treatment & Refer to Specialist Team GP sleep disturbances, insomnia Continue treatment & Refer to Specialist Team GP seizures, convulsions Discontinue drug immediately Send immediately to A&E GP/Specialist Team movement disorders, tics, tremors Continue treatment unless severe & Refer to Specialist Team GP anorexia, significant weight loss, growth retardation Continue treatment & Refer to Specialist Team GP The patient should be advised to report any of the following signs or symptoms to their GP without delay: Aggression, depression, paranoia, anxiety, suicidal thinking or self-harming behaviour Cardiac symptoms – racing pulse, increased heart rate, chest pain Uncontrollable muscle movements Other important co morbidities: Autistic Spectrum Disorder, Tourette syndrome, Depression, Anxiety Any adverse reaction to a black triangle drug or serious reaction to an established drug should be reported to the MHRA via the “Yellow Card” scheme. 11.Baseline investigations List of investigations / monitoring undertaken by secondary care See appendix 1 attached towards the end of this document Routine blood tests and ECGs are not recommended unless there is a clinical indication. Weight, heart rate and blood pressure should be measured on initiation by specialist. 12. Ongoing monitoring requirements to be undertaken by GP Is monitoring required? Yes (N.B. Routine blood tests and ECGs are not recommended unless there is a clinical indication) Prescribers should check local commissioning arrangements prior to implementing shared care as there may be variation in who is responsible for the physical health checks due to differences in local commissioning arrangements. Monitoring Frequency Results Action By whom Height and Weight 6 monthly All results should be plotted on centile charts If abnormal refer to Specialist Team GP BP & Pulse Before & after each dose change, and 6 monthly If abnormal refer to Specialist Team Life threatening changes should be referred to GP