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MEDICATION ANTIHYPERTENSIVES Propranolol (Inderal) Clonidine (Catapres) Guanfacine (Tenex) Intuniv ATYPICAL ANTIPSYCHOTICS Aripiprazole (Abilify) Clozapine (Clozaril) Olanzapine (Zyprexa) Paliperidone (Invega) Quetiapine (Seroquel) Risperidone (Risperdal) Ziprasidone (Geodon) TYPICAL ANTIPSYCHOTICS Chlorpromazine (Thorazine) Fluphenazine (Prolixin) Haloperidol (Haldol) Loxapine (Loxitane) Perphenazine (Trilafon) Trifluoperazine (Stelazine) Thiothixene (Navane) SSRI ANTIDEPPRESANTS Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac, Serefem) Fluvoxamine (Luvox) Sertraline (Zoloft) TRICYCLIC ANTIDEPRESSANTS Amitriptyline (Elavil) Clomipramine (Anafranil) Desipramine (Norpramin) Doxepin (Sinquan) Imipramine (Tofranil) Nortriptyline (Aventyl, Pamelor)

DCF PSYCHOTROPIC MEDICATION MONITORING MAXIMUM DAILY DOSAGES May 2011 SUGGESTED MAXIMUM DAILY DOSAGE

60mg if <35kg, 120mg if >35kg based on TBW for children & adolescents ages 1-17 yrs old.

0.4mg for children and adolescents 4mg for children and adolescents 30mg for children and adolescents 300mg for children 600mg for adolescents 12.5mg for children 20mg for adolescents 6mg for adolescents <51kg 12mg for adolescents >51kg 600mg for children 800mg for adolescents 4mg for children 6mg for adolescents 160mg for children 180mg for adolescents 200mg for children 400mg for adolescents 5mg for children 10mg for adolescents 4mg for children 10mg for adolescents 100mg 12mg for children 32mg for adolescents 10mg for children 15mg for adolescents 7mg for children 20mg for adolescents 60mg for children and adolescents 20mg for children and adolescents 60mg for children 80mg for adolescents 200mg for children 300mg for adolescents 200mg for children and adolescents 3mg/kg for children based on TBW, 200mg for adolescents. 3mg/kg or 200mg (whichever is smaller) for children and adolescents based on TBW. 5mg/kg for children based on TBW, 150mg for adolescents. 300mg for adolescents (no data available for children). 5mg/kg for children based on TBW, 300mg for adolescents. 150mg for adolescents.

DCF PSYCHOTROPIC MEDICATION MONITORING MAXIMUM DAILY DOSAGES May 2011 MISC. ANTIDEPRESSANTS Bupropion (Wellbutin, Wellbutrin XL, SR) Mirtazapine (Remeron) Venlafaxine (Effexor, Effexor XR) STIMULANTS Amphetamine (Adderall, Adderall XR) Dextroamphetamine (Dexedrine, Dextrostat) Lisdexamfetamine (Vyvanse) Methylphenidate (Focalin, Focalin XR) Methylphenidate

(Metadate CD, Metadate ER, Methylin, Methylin ER, Ritalin,Ritalin SR, Ritalin LA)

300mg for children, 450mg for adolescents. 45mg 50mg for children and adolescents <30kg 75mg for children and adolescents >30kg < 50kg: 40mg/day > 50kg: 60mg/day < 50kg: 40mg/day > 50kg: 60mg/day 70mg/day 50mg/day < 50kg: 60mg/day > 50kg: 100mg/day 108mg/day 30mg/day

Methylphenadate (Concerta) Methylphenadate Patch (Daytrana Patch) NON-STIMULANT ADHD MEDICATION Atomoxetine (Strattera) Bupropion (Wellbutin, Wellbutrin XL, SR) MOOD STABILIZERS Carbamazepine

100mg 450mg < 6 yo: 35mg/kg/day 6-15 yo: 1000mg/day 16-18 yo: 1200mg/day Therapeutic Range = 4-12 mcg/ml 2-12 yo: 200mg/day >12 yo: 400mg/day Dosing regimen dependent on concomitant antiepileptic therapy. · <12 yo: safety and efficacy not established · if under 25kg: 600mg · 25-39kg: 900mg · 40-50kg: 1200 · >50kg: 1500mg · final dose should be guided by serum levels Therapeutic Range = 0.6-1.2 mEq/L · <10 yo: safety and efficacy not established · 10 yo: 60mg/kg/day · children's range is up to 1200mg · adolescent's range is up to 2500 · final dose should be guided by serum levels Therapeutic Range = 50-125 mcg/ml

Lamotrigine (Lamictal)

Lithium

Valproic Acid

DCF PSYCHOTROPIC MEDICATION MONITORING MAXIMUM DAILY DOSAGES May 2011 OTHER ANTIANXIETY MEDICATIONS OR SLEEP AIDS Diphenhydramine (Benadryl) Hydroxyzine (Atarax) Hydroxyzine pamoate (Vistaril) Trazodone BENZODIAZEPINES Alprazolam (Xanax) Chlordiazapoxide (Librium) Clonazepam (Klonopin) Diazepam (Valium) Lorazepam (Ativan) Oxazepam (Serax) Buspirone (Buspar) Zolpidem (Ambien) Zaleplon (Sonata) MEDICATIONS TO COUNTERACT ANTICHOLINERGIC SIDE EFFECTS Benztropine (Cogentin) Amantadine (Symmetrel) Trihexyphenidyl (Artane) OPIOID ANTAGONIST MEDICATION FOR SELF-INJURIOUS BEHAVIOR Naltrexone (Revia) 300mg 100mg 6mg/kg for children and adolescents 6-18 yrs old based on TBW to a maximum dose of 200mg/day. 0.25mg for situational anxiety 30mg for >=6 yrs old. 2mg 10mg 0.08mg.kg up to a maximum dose of 4mg/day. For children >12 yrs old up to a maximum dose of 120mg/day. 40mg for children 60mg for adolescents 10mg 5mg 6mg 150mg for children 1-9 yrs old, 200mg for >=10 yrs old. 0.75mg/kg based on TBW for children and adolescents up to a maximum of 30mg/day. 2-3mg/kg/day

References: Clinical Manual of Child and Adolescent Psychopharmacology, Robert L. Findling MD, 2008 Pediatric Psychopharmacology Fast Facts, Daniel F. Connor MD, Bruce M Meltzer, 2006 Clinical Handbood of Psychotropic Drugs for Children and Adolescents 2nd Revision, Kalyna Z. BezchlibnykBlutler, Adil S. Virani, 2007 Child and Adolescent Clinical Psychopharmacology 4th edition, Wayne Hugo Green, 2007 Psychotropic Medication Utilization Parameters for Foster Children; Texas Department of State Health Services American Academy of Child and Adolescent Psychiatry Practice Parameters for the assessment and treatment of children and adults with attention-deficit/hyperactivity disorder Pediatric Lexi-Drugs, Lexi-Comp Institutional Drugdex Evaluations, Micromedex 1.0

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