# 56 - References

# References

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The Maudsley® Prescribing Guidelines in Psychiatry
CHAPTER 5
Doses of commonly used psychotropic drugs in children 
and adolescents
Commonly used psychotropic drugs are presented in Table 5.12.
References
1. Paediatric Formulary Committee. BNF for Children (online). London: BMJ, Pharmaceutical Press, and RCPCH Publications; http://www.
medicinescomplete.com.
2. Merative US LP. Micromedex. 2024; https://www.micromedexsolutions.com/home/dispatch/.
3. Gov.UK. Guidance: Valproate use by women and girls. 2018 (last updated January 2024); https://www.gov.uk/guidance/valproate-­use-­by- 
­women-­and-­girls.
Table 5.12  Starting doses of commonly used psychotropic drugs in children and adolescents.1,2
Drug
Starting dose*
Comment
Antipsychotics
Aripiprazole
2mg
Adjust dose according to response and adverse effects.
Clozapine
6.­25–­12.5mg
Use plasma levels to determine maintenance dose.
Lurasidone
18.5mg (20mg) 
to 37mg (40mg)
Adjust dose according to response and adverse effects.
Olanzapine
2.­5–­5mg
Adjust dose according to response and adverse effects.
Quetiapine
25mg
Effective dose usually in the range ­150–­200mg daily.
Risperidone
0.­25–­2mg
Adjust dose according to response and adverse effects.
Antidepressants
Citalopram
10mg daily
Effective dose ­10–­40mg (note QT effects)
Escitalopram
5mg/day
Effective dose ­10–­20mg (note QT effects)
Fluoxetine
­5–­10mg/day
Adjust dose according to response and adverse effects.
Sertraline
25mg daily
Effective dose usually in the range ­50–­100mg daily.
Other drugs
Lithium
­100–­200mg/day
lithium carbonate
Use plasma levels to determine maintenance dose.
Melatonin
­1–­2mg at night
Effective dose ­2–­10mg
Valproate
­10–­20mg/kg/day 
in divided doses
Use plasma levels to determine maintenance dose. Do not 
offer valproate to girls or young women of child-­bearing 
potential unless there is a pregnancy prevention 
programme (PPP) in place.1,3
*Suggested approximate oral starting doses (see primary literature for doses in individual indications). Lower dose in 
suggested range is for children weighing less than 25kg.