Terms of Use

References

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US Food and Drug Administration (2013). Drug Safety Communication: Risk of next-morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidem. Available at: https://www.fda.gov/drugs/drug-safety-and-availability

Tracy TS, Venkataramanan R, Glover DD, Caritis SN (for the National Institute for Child Health and Human Development Network of Maternal-Fetal-Medicine Units). Temporal changes in drug metabolism (CYP1A2, CYP2D6 and CYP3A activity) during pregnancy. American Journal of Obstetrics and Gynecology 2005;192(2):633-639. doi:10.1016/j.ajog.2004.08.030

Anderson GD. Pregnancy-induced changes in pharmacokinetics: a mechanistic-based approach. Clinical Pharmacokinetics 2005;44(10):989-1008. doi:10.2165/00003088-200544100-00001

Hebert MF, Easterling TR, Kirby B, Carr DB, Buchanan ML, Rutherford T, Thummel KE, Fishbein DP, Unadkat JD. Effects of pregnancy on CYP3A and P-glycoprotein activities as measured by disposition of midazolam and digoxin: a University of Washington specialized center of research study. Clinical Pharmacology and Therapeutics 2008;84(2):248-253. doi:10.1038/clpt.2008.1

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Hiemke C, Bergemann N, Clement HW, Conca A, Deckert J, Domschke K, Eckermann G, Egberts K, Gerlach M, Greiner C, Grunder G, Haen E, Havemann-Reinecke U, Hefner G, Helmer R, Janssen G, Jaquenoud E, Laux G, Messer T, Mossner R, Muller MJ, Paulzen M, Pfuhlmann B, Riederer P, Saria A, Schoppek B, Schoretsanitis G, Schwarz M, Gracia MS, Stegmann B, Steimer W, Stingl JC, Uhr M, Ulrich S, Unterecker S, Waschgler R, Zernig G, Zurek G, Baumann P. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry 2018;51(1-2):9-62. doi:10.1055/s-0043-116492

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Stahl SM. Prescriber's Guide: Stahl's Essential Psychopharmacology. 8th edition. Cambridge: Cambridge University Press, 2024.

Stahl SM. Prescriber's Guide: Stahl's Essential Psychopharmacology. 6th edition. Cambridge: Cambridge University Press, 2017.

Taylor DM, Barnes TRE, Young AH. The Maudsley Prescribing Guidelines in Psychiatry. 15th edition. Chichester: Wiley-Blackwell, 2025.

Gee S, Taylor DM. The Maudsley Guidelines for Mental Health Conditions in Physical Illness. 1st edition. Chichester: Wiley-Blackwell, 2025.

Fagiolini A, Cuomo A, McIntyre RS. Pocket Guide to Practical Psychopharmacology: SSRIs and SNRIs. Cham: Springer, 2024.

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Electronic Medicines Compendium (EMC). Available at: https://www.medicines.org.uk/emc

All SmPCs below available at the Electronic Medicines Compendium (https://www.medicines.org.uk/emc): Concerta XL (methylphenidate prolonged-release), Elvanse (lisdexamfetamine), Circadin (melatonin prolonged-release), Slenyto (melatonin prolonged-release for paediatric ASD/ADHD insomnia), Seroquel XL (quetiapine prolonged-release), Latuda (lurasidone), Reagila (cariprazine), Invega (paliperidone), Abilify (aripiprazole), Zyprexa (olanzapine), Risperdal (risperidone), Haldol (haloperidol), Clozaril (clozapine), Priadel (lithium), Epilim (sodium valproate), Lamictal (lamotrigine), Tegretol (carbamazepine), Lyrica (pregabalin), Neurontin (gabapentin), Buspirone (buspirone hydrochloride), Rivotril (clonazepam), Dayvigo (lemborexant), Catapres (clonidine), Nalorex (naltrexone), Campral (acamprosate), Antabuse (disulfiram), Provigil (modafinil) and Kemadrin (procyclidine).

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Raffa RB, Friderichs E, Reimann W, Shank RP, Codd EE, Vaught JL. Opioid and nonopioid components independently contribute to the mechanism of action of tramadol, an 'atypical' opioid analgesic. Journal of Pharmacology and Experimental Therapeutics 1992;260(1):275-285.

Gillman PK. Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity. British Journal of Anaesthesia 2005;95(4):434-441.

Nelson EM, Philbrick AM. Avoiding serotonin syndrome: the nature of the interaction between tramadol and selective serotonin reuptake inhibitors. Annals of Pharmacotherapy 2012;46(12):1712-1716.

Kirchheiner J, Schmidt H, Tzvetkov M, Keulen JT, Lotsch J, Roots I, Brockmoller J. Pharmacokinetics of codeine and its metabolite morphine in ultra-rapid metabolizers due to CYP2D6 duplication. Pharmacogenomics Journal 2007;7(4):257-265.

Koren G, Cairns J, Chitayat D, Gaedigk A, Leeder SJ. Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet 2006;368(9536):704.

Rowell FJ, Seymour RA, Rawlins MD. Pharmacokinetics of intravenous and oral dihydrocodeine and its acid metabolite. European Journal of Clinical Pharmacology 1983;25(3):419-424.

Webb JA, Rostami-Hodjegan A, Abdul-Manap R, Lennard MS, Tucker GT. Contribution of dihydrocodeine and dihydromorphine to analgesia following dihydrocodeine administration in man: a PK-PD modelling analysis. British Journal of Clinical Pharmacology 2001;52(1):35-43.

Joint Formulary Committee. British National Formulary: Tramadol hydrochloride. London: BMJ Group and Pharmaceutical Press. Available at: https://bnf.nice.org.uk (Accessed April 2026).

Joint Formulary Committee. British National Formulary: Codeine phosphate. London: BMJ Group and Pharmaceutical Press. Available at: https://bnf.nice.org.uk (Accessed April 2026).

Zamadol SR 100mg Summary of Product Characteristics (SmPC). Electronic Medicines Compendium (EMC). Available at: https://www.medicines.org.uk/emc (Accessed April 2026).

DF118 Forte 40mg Tablets Summary of Product Characteristics (SmPC). Electronic Medicines Compendium (EMC). Available at: https://www.medicines.org.uk/emc (Accessed April 2026).

Jick H, Derby LE, Vasilakis C, Fife D. The risk of seizures associated with tramadol. Pharmacotherapy 1998;18(3):607-611.

Desmeules J, Gascon MP, Dayer P, Magistris M. Impact of environmental and genetic factors on codeine analgesia. European Journal of Clinical Pharmacology 1991;41(1):23-26.

Part 5 — Paediatric data sources and key references

Paediatric dosing, licensing, pharmacokinetic band multipliers, and monitoring guidance in DoseCurve's paediatric mode are derived primarily from the BNF for Children, MHRA Drug Safety Updates, and published paediatric psychopharmacology studies. The three age bands (6–11, 12–14, 15–17) approximate PK changes driven by developmental differences in hepatic enzyme expression (especially CYP1A2, CYP2D6, CYP3A4), body composition, and renal clearance — not a substitute for therapeutic drug monitoring or specialist paediatric pharmacology advice.

Paediatric licensing is indication-specific. For example, sertraline is licensed in the UK for OCD in children aged 6+ but not for depression under 18 (off-label); fluoxetine is the only SSRI licensed for paediatric depression (8+); paroxetine is contraindicated by the MHRA in under-18s for any psychiatric indication. DoseCurve encodes these distinctions per-drug but the prescribing clinician is responsible for verifying the current UK label before prescribing.

BNF for Children. Joint Formulary Committee, Royal College of Paediatrics and Child Health, Neonatal and Paediatric Pharmacists Group. London: BMJ Group and Pharmaceutical Press. Available at: https://bnfc.nice.org.uk

NICE NG87. Attention deficit hyperactivity disorder: diagnosis and management. March 2018, updated 2019.

NICE NG134. Depression in children and young people: identification and management. June 2019.

NICE CG155. Psychosis and schizophrenia in children and young people: recognition and management. January 2013, updated March 2016.

NICE CG158. Antisocial behaviour and conduct disorders in children and young people: recognition and management. March 2013, updated April 2017.

NICE CG170. Autism spectrum disorder in under 19s: support and management. August 2013.

Kearns GL, Abdel-Rahman SM, Alander SW, Blowey DL, Leeder JS, Kauffman RE. Developmental pharmacology — drug disposition, action, and therapy in infants and children. N Engl J Med 2003;349(12):1157–1167. doi:10.1056/NEJMra035092

Batchelor HK, Marriott JF. Paediatric pharmacokinetics: key considerations. Br J Clin Pharmacol 2015;79(3):395–404. doi:10.1111/bcp.12267

Johnson TN. The problems in scaling adult drug doses to children. Arch Dis Child 2008;93(3):207–211. doi:10.1136/adc.2006.114835

Hines RN. The ontogeny of drug metabolism enzymes and implications for adolescent drug therapy. J Pharmacol Exp Ther 2008;327(1):1–10. doi:10.1124/jpet.107.134130

Bridge JA, Iyengar S, Salary CB, Barbe RP, Birmaher B, Pincus HA, Ren L, Brent DA. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis. JAMA 2007;297(15):1683–1696. doi:10.1001/jama.297.15.1683

Cortese S, Adamo N, Del Giovane C, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet Psychiatry 2018;5(9):727–738. doi:10.1016/S2215-0366(18)30269-4

Findling RL, McNamara NK. Atypical antipsychotics in the treatment of children and adolescents: clinical applications. J Clin Psychiatry 2004;65(Suppl 6):30–44.

Blader JC, Carlson GA. Increased rates of bipolar disorder diagnoses among U.S. child, adolescent, and adult inpatients, 1996–2004. Biol Psychiatry 2007;62(2):107–114. doi:10.1016/j.biopsych.2006.11.006

Posey DJ, McDougle CJ. The pharmacotherapy of target symptoms associated with autistic disorder and other pervasive developmental disorders. Harv Rev Psychiatry 2000;8(2):45–63. doi:10.1080/hrp_8.2.45

Appleton RE, Macleod S, Martland T. Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children. Cochrane Database Syst Rev 2008;(3):CD001905. doi:10.1002/14651858.CD001905.pub2

Sharma A, Shaw SR. Efficacy of risperidone in managing maladaptive behaviors for children with autistic spectrum disorder: a meta-analysis. J Pediatr Health Care 2012;26(4):291–299. doi:10.1016/j.pedhc.2011.02.008

Ghuman JK, Arnold LE, Anthony BJ. Psychopharmacological and other treatments in preschool children with ADHD. J Child Adolesc Psychopharmacol 2008;18(5):413–447. doi:10.1089/cap.2008.022

NICE NG217. Epilepsies in children, young people and adults. April 2022.

NICE CG185. Bipolar disorder: assessment and management. 2014, updated February 2020.

Taylor DM, Barnes TRE, Young AH. The Maudsley Prescribing Guidelines in Psychiatry, 15th Edition — Children and Adolescents chapter. 2025.

Vitiello B, Perez Algorta G, Arnold LE, Howard AL, Stehli A, Molina BSG. Psychotic symptoms in attention-deficit/hyperactivity disorder: an analysis of the MTA database. J Am Acad Child Adolesc Psychiatry 2017;56(4):336–343. doi:10.1016/j.jaac.2017.01.016

MHRA Drug Safety Update. Paroxetine: SSRIs not recommended in under 18s for major depressive disorder. June 2003.

Medicines for Children. Royal College of Paediatrics and Child Health and Neonatal and Paediatric Pharmacists Group patient information leaflets. https://www.medicinesforchildren.org.uk