01/09
DCF PSYCHOTROPIC MEDICATION MONITORING
MAXIMUM DAILY DOSAGES
MEDICATION                  SUGGESTED MAXIMUM DAILY
DOSAGE
ANTIHYPERTENSIVES
Atenolol (Tenormin)                      No data
Metoprolol (Lopressor)               No data
Nadolol (Corgard)                         200mg
Propranolol (Inderal)                     120mg
Verapamil                                         240mg for children 1-5 years  /  320mg for children > 5 years
Clonidine (Catapres)                      0.4mg for children and adolescents
Guanfacine (Tenex)                        4mg for children and adolescents
ATYPICAL ANTIPSYCHOTICS
Aripiprazole (Abilify)                    30mg for children and adolescents
Clozapine (Clozaril)                      300mg for children  /  600mg for adolescents
Olanzapine (Zyprexa)                    12.5mg for children  /  20mg for adolescents
Quetiapine (Seroquel)                     600mg for children  /  800mg for adolescents
Risperidone (Risperdal)                 4mg for children  /  6mg for adolescents
Ziprasidone (Geodon)                   160mg for children  /  180mg for adolescents
TYPICAL ANTIPSYCHOTICS
Chlorpromazine (Thorazine)       200mg for children  /  375mg for adolescents
Fluphenazine (Prolixin)                  5mg for children  /  10mg for adolescents
Haloperidol (Haldol)                      4mg for children  /  10mg for adolescents
Loxapine (Loxitane)                      100mg
Molindone (Moban)                      No data
Perphenazine (Trilafon)                12mg for children  /  32mg for adolescents
Trifluoperazine (Stelazine)           10mg for children  /  15mg for adolescents
Thiothixene (Navane)                   7mg for children  /  20mg for adolescents
SSRI ANTIDEPPRESANTS
Citalopram (Celexa)                      60mg for children and adolescents
Escitalopram (Lexapro)               20mg for children and adolescents
Fluoxetine (Prozac, Serefem)      20mg for children  /  40mg for adolescents
Fluvoxamine (Luvox)                   200mg for children  /  01/09  /  300mg for adolescents
Sertraline (Zoloft)                          200mg for children and adolescents
TRICYCLIC ANTIDEPRESSANTS
Amitriptyline (Elavil)                     300mg
Clomipramine (Anafranil)             200mg
Desipramine (Norpramin)            150mg
Doxepin (Sinquan)                         300mg
Imipramine (Tofranil)                   300mg
Nortriptyline (Aventyl, Pamelor)150mg
MISC. ANTIDEPRESSANTS
Bupropion (Wellbutin, Wellbutrin XL, SR)        450mg
Mirtazapine (Remeron)                                        45mg
STIMULANTS
Amphetamine (Adderall, Adderall XR)              < 50kg: 40mg/day  /  > 50kg: 60mg/day
Dextroamphetamine (Dexedrine, Dextrostat) < 50kg: 40mg/day  /  > 50kg: 60mg/day
Lisdexamfetamine (Vyvanse)                             70mg/day
Methylphenidate (Focalin, Focalin XR)           50mg/day
Methylphenidate (Metadate CD, Metadate      < 50kg: 60mg/day
ER, Methylin, Methylin ER, Ritalin,                   > 50kg: 100mg/day
Ritalin SR, Ritalin LA)
Methylphenadate (Concerta)                              108mg/day
Methylphenadate Patch (Daytrana Patch)       30mg/day
NON-STIMULANT ADHD
MEDICATION
Atomoxetine (Strattera)                                     100mg
Bupropion (Wellbutin, Wellbutrin XL, SR)                    450mg
MOOD STABILIZERS
Carbamazepine                                        < 6 yo: 35mg/kg/day
6-15 yo: 1000mg/day
16-18 yo: 1200mg/day
Therapeutic Range = 4-12 mcg/ml
Lamotrigine (Lamictal)                               2-12 yo: 200mg/day
>12 yo: 400mg/day
Dosing regimen dependent on concomitant
antiepileptic therapy.
• <12 yo: safety and efficacy not
Lithium
established
• if under 25kg: 600mg
• 25-39kg: 900mg
• 40-50kg: 1200
• >50kg: 1500mg
01/09
•    final dose should be guided by
serum levels
Therapeutic Range = 0.6-1.2 mEq/L
• <10 yo: safety and efficacy not
Valproic Acid
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
OTHER ANTIANXIETY
MEDICATIONS OR SLEEP AIDS
Diphenhydramine (Benadryl)                                         300mg
Hydroxyzine (Atarax)                                               100mg
Hydroxyzine pamoate (Vistaril)
Trazodone                                                          200mg
BENZODIAZEPINES
Alprazolam (Xanax)                                    0.25mg for situational anxiety
Chlordiazapoxide (Librium)                       The usual dose is 5mg 2-4 times a day.
This may be increased in some children to
10mg 2-3 times a day.
Clonazepam (Klonopin)                                                2mg
Diazepam (Valium)                                                   10mg
Lorazepam (Ativan)                                               0.8mg.kg
Oxazepam (Serax)                                Not approved for children under age of 6.
120mg
Buspirone (Buspar)                                           40mg for children
60mg for adolescents
Zolpidem (Ambien)                                                   10mg
Zaleplon (Sonata)                                                    5mg
MEDICATIONS TO COUNTERACT
ANTICHOLINERGIC SIDE EFFECTS
Benztropine (Cogentin)                                               6mg
Amantadine (Symmetrel)                                      200mg for children
300mg for adolescents
Trihexyphenidyl (Artane)                                            30mg
OPIOID ANTAGONIST
MEDICATION FOR SELF-
INJURIOUS BEHAVIOR
Naltrexone (Revia)                                             2-3mg/kg/day
References:
Clinical Manual of Child and Adolescent Psychopharmacology, Robert L. Findling MD, 2008
01/09
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.
Bezchlibnyk-Blutler, 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

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