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Trade Names Psychotropic Medications Xanax ALPRAZOLAM Xanax XR ALPRAZOLAM Limbitrol /CHLORDIAZEPOXIDE Limbitrol DS AMITRIPTYLINE/CHLORDIAZEPOXIDE Elavil AMITRIPTYLINE HCL Amytal AMOBARBITAL Asendin Abilify Aristada Nuvigil Saphris MALEATE Strattera HCL Rexulti Briviact Aplenzin HBR Wellbutrin SR BUPROPION HCL Wellbutrin XL BUPROPION HCL Forfivo XL BUPROPION HCL Zyban BUPROPION HCL Buspar HCL Tegretol Tegretol XR CARBAMAZEPINE Equetro CARBAMAZEPINE Epitol CARBAMAZEPINE Vraylar HCL Librium CHLORDIAZEPOXIDE HCL Librax CHLORDIAZEPOXIDE/CLIDINIUM BR Thorazine HCL Largactil CHLORPROMAZINE HCL Ormazine CHLORPROMAZINE HCL Celeza HYDROBROMIDE Anafranil HCL Klonopin Catapres HCL Kapvay CLONIDINE HCL Tranxene DIPOTASSIUM Clozaril Fazaclo ODT CLOZAPINE Versacloz CLOZAPINE Norpramin HCL Pertofrane DESIPRAMINE HCL Pristiq Focalin HCL Focalin XR DEXMETHYLPHENIDATE HCL Dexedrine DEXTROAMPHETAMINE SULFATE Adderall DEXTROAMPHETAMINE/ Adderall XR DEXTROAMPHETAMINE/AMPHETAMINE Mydayis DEXTROAMPHETAMINE/AMPHETAMINE Valium Depakote DIVALPROEX SODIUM Depakote ER DIVALPROEX SODIUM Depakote Sprinkles DIVALPROEX SODIUM Silenor HCL Sinequan DOXEPIN HCL Cymbalta HCL Cipralex OXALATE Lexapro ESCITALOPRAM OXALATE Aptiom Zebinix ESLICARBAZEPINE ACETATE Zarontin Peganone Trobalt EZOGABINE Potiga EZOGABINE Felbatol Prozac HCL Sarafem FLUOXETINE HCL Permitil DECANOATE Prolixin Deconaote (INJ) FLUPHENAZINE DECANOATE Prolixin Elixir FLUPHENAZINE HCL Modecate FLUPHENAZINE HCL Luvox MALEATE Cerebyx (INJ) SODIUM Neurontin Horizant Tenex HCL Haldol Haldol Decanoate (AMP) Peridol HALOPERIDOL DECANOATE Haloperidol LA HALOPERIDOL DECANOATE Haldol (AMP) HALOPERIDOL LACTATE Fanapt Zomaril ILOPERIDONE Tofranil HCL Tofranil-PM IMIPRAMINE PAMOATE Marplan Vimpat Lamictal Keppra Fetzima HCL Vyvanse LISDEXAMFETAMINE DIMESYLATE Eskalith CR CARBONATE Lithobid Lithium Ativan Loxitane Loxitane LOXAPINE SUCCINATE Latuda HCL Ludiomil HCL Miltown MEPROBAMATE Equanil MEPROBAMATE Desoxyn HCL Methedrine METHAMPHETAMINE HCL Celontin METHSUXIMIDE Ritalin Ritalin LA METHYLPHENIDATE Concerta METHYLPHENIDATE Metadate CD METHYLPHENIDATE Methylin METHYLPHENIDATE Methylin ER METHYLPHENIDATE Quillivant XR METHYLPHENIDATE Quillichew ER METHYLPHENIDATE Aptensio XR METHYLPHENIDATE Cotemplat XR-ODT METHYLPHENIDATE Jornay PM METHYLPHENIDATE Adhansia XR METHYLPHENIDATE Daytrana (PTCH) METHYLPHENIDATE Versed Remeron Provigil Moban HCL Serzone HCL Dutonin NEFAZODONE HCL Nefadar NEFAZODONE HCL Pamelor HCL Zyprexa Symbyax OLANZAPINE/FLUOXETINE HCL Serax OXAZEPAM Alepam OXAZEPAM Trileptal Oxtellar XR OXCARBAZEPINE Invega Invega Sustenna PALIPERIDONE PALMITATE Invega Trinza (INJ) PALIPERIDONE PALMITATE Paxil HCL Paxil CR PAROXETINE HCL Brisdelle PAROXETINE MESYLATE Pexeva PAROXETINE MESYLATE Nembutal (INJ) SODIUM Fycompa Trilafon Etrafon PERPHENAZINE/AMITRIPTYLINE HCL Triavil PERPHENAZINE/AMITRIPTYLINE HCL Triptafen PERPHENAZINE/AMITRIPTYLINE HCL Nardil SULFATE Solfoton Dilantin Dilantin PHENYTOIN SODIUM Dilantin PHENYTOIN SODIUM EXTENDED Nuplazid TARTRATE Orap Lyrica Mysoline Vivactil HCL Seroquel FUMARATE Risperdal Risperdal Consta (INJ) RISPERIDONE MICROSPHERES Banzel Seconal Sodium SECOBARBITAL SODIUM Emsam Eldepryl, SELEGILINE Zelapar SELEGILINE Zoloft HCL Alcover SODIUM OXYBATE Gamma-OH SODIUM OXYBATE Natril SODIUM OXYBATE Oxybutyras SODIUM OXYBATE Kalceks SODIUM OXYBATE Somsanit SODIUM OXYBATE Xyrem SODIUM OXYBATE Diacomit Mellaril HCL Navane THIOTHIXENE Gabitril HCL Topamax Parnate SULFATE Desyrel HCL Desyrel Dividose TRAZODONE HCL Oleptro TRAZODONE HCL Trazodone D TRAZODONE HCL Stelazine HCL Surmontil MALEATE Depakene VALPROIC ACID Stavzor VALPROIC ACID Depacon VALPROIC ACID Convulex VALPROIC ACID (AS SODIUM SALT) Depakote VALPROIC ACID (AS SODIUM SALT) Epilime VALPROIC ACID (AS SODIUM SALT) Stavzor VALPROIC ACID (AS SODIUM SALT) VALPROIC ACID (AS SODIUM SALT) Effexor HCL Sabril Viibryd HCL Trintellix HYDROBROMIDE Brintellix VORTIOXETINE HYDROBROMIDE Geodon HCL Geodon ZIPRASIDONE MESYLATE (Injection) Zonegran

+ Children’s Division has implemented an Excessive Dosage Guide for children in foster care 1 Psychotropic Medication Advisory Committee (PMAC). Updates will be posted at least annuall

DISCLAIMER: THE CHILDREN'S DIVISION EXCESSIVE DOSAGE GUIDE DOES NOT PROVIDE MEDIC

The information contained herein regarding Excessive Dosage Guide is for informational purpose advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healt condition or treatment. The Excessive Dosage Guide will be reviewed and updated by UMKC and Dosage Subcommittee. Official version of the Excessive Dosage Guide is maintained at the Department of Social Services website. Last updated and approved+: 11/30/2020

7 and under. The current recommendations were created by the ly.

CAL ADVICE

es only and is not intended to be a substitute for professional medical h care provider with any questions you may have regarding a medical d the Psychotropic Medication Advisory Committee – Excessive

Trade Names Generic name

Xanax, Xanax XR ALPRAZOLAM

Elavil AMITRIPTYLINE HCL

Limbitrol, Limbitrol DS AMITRIPTYLINE/CHLORDIAZEPOXIDE

* Amytal AMOBARBITAL SODIUM

Asendin AMOXAPINE

Abilify ARIPIPRAZOLE

Aristada ARIPIPRAZOLE LAUROXIL

Nuvigil ARMODAFINIL

Saphris ASENAPINE MALEATE

Strattera ATOMOXETINE HCL

Rexulti BREXPIPRAZOLE * Briviact BRIVARACETAM

Aplenzin BUPROPION HBR Wellbutrin SR, Wellbutrin XL, Forfivo XL, Zyban BUPROPION HCL

Buspar BUSPIRONE HCL

* Tegretol, Tegretol XR, Equetro, Epitol CARBAMAZEPINE

Vraylar CARIPRAZINE HCL

Librium CHLORDIAZEPOXIDE HCL

Librax CHLORDIAZEPOXIDE/CLIDINIUM BR

Thorazine, Largactil, Ormazine CHLORPROMAZINE HCL

Celexa CITALOPRAM HYDROBROMIDE

Anafranil CLOMIPRAMINE HCL

Klonopin CLONAZEPAM Catapres, Kapvay CLONIDINE HCL

* Tranxene CLORAZEPATE DIPOTASSIUM

Clozaril, Fazaclo ODT, Versacloz CLOZAPINE

Norpramin, Pertofrane DESIPRAMINE HCL

Pristiq DESVENLAFAXINE

Focalin, Focalin XR DEXMETHYLPHENIDATE HCL

Dexedrine DEXTROAMPHETAMINE SULFATE

Adderall, Adderall XR, Mydayis DEXTROAMPHETAMINE/AMPHETAMINE

* Valium DIAZEPAM Depakote, Depakote ER, Depakote * Sprinkles DIVALPROEX SODIUM

Silenor, Sinequan DOXEPIN HCL Cymbalta DULOXETINE HCL

Cipralex, Lexapro ESCITALOPRAM OXALATE

* Aptiom, Zebinix ESLICARBAZEPINE ACETATE

* Zarontin ETHOSUXIMIDE

* Peganone ETHOTOIN

* Trobalt, Potiga EZOGABINE

* Felbatol FELBAMATE

Prozac, Sarafem FLUOXETINE HCL

Permitil, Prolixin Deconaote (INJ) FLUPHENAZINE DECANOATE

Prolixin Elixir, Modecate FLUPHENAZINE HCL

Luvox FLUVOXAMINE MALEATE

* Cerebyx (INJ) FOSPHENYTOIN SODIUM

* Neurontin GABAPENTIN

* Horizant GABAPENTIN ENACARBIL Tenex GUANFACINE HCL

Haldol HALOPERIDOL Haldol Decanoate (AMP), Peridol, Haloperidol LA HALOPERIDOL DECANOATE

Haldol (AMP) HALOPERIDOL LACTATE

Fanapt, Zomaril ILOPERIDONE

Tofranil IMIPRAMINE HCL

Tofranil-PM IMIPRAMINE PAMOATE

Marplan ISOCARBOXAZID

* Vimpat LACOSAMIDE

* Lamictal LAMOTRIGINE

* Keppra LEVETIRACETAM

Fetzima LEVOMILNACIPRAN HCL

Vyvanse LISDEXAMFETAMINE DIMESYLATE

Eskalith CR, Lithobid LITHIUM CARBONATE Lithium LITHIUM CITRATE

Ativan LORAZEPAM

Loxitane LOXAPINE

Loxitane LOXAPINE SUCCINATE

Latuda LURASIDONE HCL

Ludiomil MAPROTILINE HCL

Miltown, Equanil MEPROBAMATE

Desoxyn, Methedrine METHAMPHETAMINE HCL

* Celontin METHSUXIMIDE

Ritalin, Ritalin LA, Concerta, Metadate CD, Methylin, Methylin ER, Quillivant XR, Quillichew ER, Aptensio XR, Cotemplat XR-ODT, Jornay PM, Adhansia XR, Daytrana (PTCH) METHYLPHENIDATE

* Versed MIDAZOLAM

Remeron MIRTAZAPINE

Provigil MODAFINIL Moban MOLINDONE HCL

Serzone, Dutonin, Nefadar NEFAZODONE HCL

Pamelor NORTRIPTYLINE HCL

Zyprexa OLANZAPINE

Symbyax OLANZAPINE/FLUOXETINE HCL

Serax, Alepam OXAZEPAM

* Trileptal, Oxtellar XR OXCARBAZEPINE

Invega PALIPERIDONE

Invega Sustenna, Invega Trinza (INJ) PALIPERIDONE PALMITATE

Paxil, Paxil CR PAROXETINE HCL

Brisdelle, Pexeva PAROXETINE MESYLATE

* Nembutal (INJ) PENTOBARBITAL SODIUM

* Fycompa PERAMPANEL

Trilafon PERPHENAZINE Etrafon, Triavil, Triptafen PERPHENAZINE/AMITRIPTYLINE HCL

Nardil PHENELZINE SULFATE

* Solfoton PHENOBARBITAL

* Dilantin PHENYTOIN

* Dilantin PHENYTOIN SODIUM

* Dilantin PHENYTOIN SODIUM EXTENDED

* Nuplazid PIMAVANSERIN TARTRATE

Orap PIMOZIDE

* Lyrica PREGABALIN

* Mysoline PRIMIDONE

Vivactil PROTRIPTYLINE HCL

Seroquel QUETIAPINE FUMARATE

Risperdal RISPERIDONE Risperdal Consta (INJ) RISPERIDONE MICROSPHERES

* Banzel RUFINAMIDE

* Seconal Sodium SECOBARBITAL SODIUM

Emsam, Eldepryl, Zelapar SELEGILINE

Zoloft SERTRALINE HCL

Alcover, Gamma-OH, Natril, Oxybutyras, Kalceks, Somsanit, * Xyrem SODIUM OXYBATE

* Diacomit STIRIPENTOL

Mellaril THIORIDAZINE HCL

Navane THIOTHIXENE

* Gabitril TIAGABINE HCL

* Topamax TOPIRAMATE

Parnate TRANYLCYPROMINE SULFATE Desyrel, Desyrel Dividose, Oleptro, Trazodone D TRAZODONE HCL

Stelazine TRIFLUOPERAZINE HCL

Surmontil TRIMIPRAMINE MALEATE

* Depakene, Stavzor, Depacon VALPROIC ACID Convulex, Depakote, Epilim, Stavzor, * Valproate VALPROIC ACID (AS SODIUM SALT)

Effexor VENLAFAXINE HCL

* Sabril VIGABATRIN

Viibryd VILAZODONE HCL

Trintellix, Brintellix VORTIOXETINE HYDROBROMIDE

Geodon ZIPRASIDONE HCL

Geodon ZIPRASIDONE MESYLATE (Injection)

* Zonegran ZONISAMIDE

* FDA approved dose or PMAC recommended dose is for/based on non-psychiatric indication Last updated and approved+: 11/30/2020

+ Children’s Division has implemented an Excessive Dosage Guide for children in foster care 17 Psychotropic Medication Advisory Committee (PMAC). Updates will be posted at least annuall DISCLAIMER: THE CHILDREN'S DIVISION EXCESSIVE DOSAGE GUIDE DOES NOT PROVIDE MEDIC

The information contained herein regarding Excessive Dosage Guide is for informational purpose advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healt condition or treatment. The Excessive Dosage Guide will be reviewed and updated by UMKC and Dosage Subcommittee. Official version of the Excessive Dosage Guide is maintained at the Department of Social Services website. Max Dosage FDA approval or PMAC recommendation

(IF DOSE EXCEEDS WHAT IS LISTED BELOW OR SAFETY AND EFFICACY HAVE NOT BEEN ESTABLISHED - REFERRAL TO CFE IS REQUIRED PRIOR TO CONSENT)

7+ years: 3 mg

12+ years: 200 mg

12+ years: 150 mg

6+ years: 500 mg/DOSE

Safety and efficacy have not been established at this time 6-10 years: 15 mg 11+ years: 30 mg

Safety and efficacy have not been established at this time

Safety and efficacy have not been established at this time

10+ years: 20 mg 6+ years Children < 70 kg: 1.4 mg/kg/day or 100 mg

Safety and efficacy have not been established at this time 4+ yo: based on weight 11-20kg: 5 mg/kg 20-50kg: 4 mg/kg 50kg or more: 200 mg

16 + yo: 200 mg

6+ years: 300 mg

6+ years: 300 mg

6+ years: 60 mg/day 0-5 years: 35 mg/kg 6-12 years: 1 gm 13-14 years: 1 gm 15+: 1,200 mg

Safety and efficacy have not been established at this time

6+ years: 30 mg

Safety and efficacy have not been established at this time Children 5-12 years: 200 mg oral, 40 mg IM 13+ years: 500 mg oral, 75 mg IM

7+ years: 40 mg

10+ years: 200 mg

4 mg/day for psychiatric disorders Immediate Release 27-40.5kg: 0.2 mg/day 40.5-45kg: 0.3 mg/day if 45kg or more: 0.4 mg/day

Extended Release: 6+ years: 0.4 mg/day 9-12 years: 60 mg/day 13+ years: 90 mg/day

6+ years: 400 mg 6-12 years: 100 mg 13+ years: 150 mg

100 mg 6+ years: Immediate Release: 20 mg/day Extended Release: 30 mg/day

3+ years: 40 mg

Immediate Release 3+ years: 40 mg

Extended Release: 6+ years: 30 mg if 50kg or more: 60 mg

Mydayis: 25 mg

20 mg/day Divalproex sodium: 5+ years - 1000 mg 7 - 11 years: 3 mg/kg/day, 12+ years: 300 mg/day 150mg/single DOSE 7+ years: 120 mg

6+ years: 20 mg 4-17 years

11-21kg: 600 mg 22-31kg: 800 mg 32-38kg: 900 mg if 38kg or more: 1,200 mg

3+ years: 1,500 mg

1+ years: 3 gm/day

Safety and efficacy have not been established Lennox-Gastaut 2+ years: 45 mg/kg or 3,600 mg - whichever is less 8-11 years: 40 mg 12+ years: 60 mg

Safety and efficacy have not been established

Doses studied up to 24 mg/day 8 - 11 years: 200 mg; 12+ years: 300 mg

1,500 mg PE 3-4 years: 40 mg/kg 5-12 years: 35 mg/kg 13+ years: 3,600 mg Safety and efficacy of extended-release products have not been established Immediate Release: 6+ years 27-40.5kg: 2 mg; 40.5-45kg: 3 mg; 45kg or more: 4 mg

Extended Release: Children 6 to 12 years: 4 mg/day; Adolescents: 13 to 17 years: 7 mg/day.

3+ years: 15 mg/day

Safety and efficacy have not been established

3+ years: 15 mg/day

Safety and efficacy have not been established 8-12 years: 50 mg 13+ years: 100 mg

8+ years: 100 mg 0-15 years: safety and efficacy have not been established

16+ years: 60 mg/day

13+ years: 400 mg

2+ years: 200 mg 1 month - 4 years: 50 mg/kg/day 4+ years: 3000 mg

Safety and efficacy have not been established

6+ years: 70 mg 7-12 years: 900 mg/day 13+ years: 1200 mg/day 7-12 years: 24 mEq/day 13+ years: 32 mEq/day 2 mg single dose max 6 mg/day total

Safety and efficacy have not been established

Safety and efficacy have not been established

10+ years: 80 mg

Safety and efficacy have not been established

6+ years: 600 mg

6+ years: 25 mg

1200 mg/day

2 mg/kg or 60 mg,

Concerta 54 mg (age 6-12),

Concerta 72 (age 13+),

Contempla XR ODT 51.8 mg,

Jornay PM 100 mg, 0-5 years: 6 mg 6+ years: 10 mg

30 mg if under 30 kg: 200 mg if 30kg or more: 300 mg 12+ years: 225 mg

Safety and efficacy have not been established

6+ years: 100 mg

6+ years: 20 mg

10+ years: 12mg/50mg

12+ years: 120 mg 2-4 years: 60 mg/kg/day

5+ years max dose by weight: 20-29 kg: 900 mg 29.1-39 kg: 1200 mg 39 kg or more: 1800 mg

12+ years: 12 mg 7+ years Based on literature review: 234 mg monthly

Monitor closely for side effects

7+ years: 60 mg

7+ years: 60 mg

100 mg

4+ years: 12 mg

12+ years: 32 mg < 12 years: Safety and efficacy have not been established

12+ years outpatient: Amitriptyline max dose: 150 mg/day PO Perphenazine max dose: 24 mg/day PO (up to 64 mg/day for short periods) Safety and efficacy have not been established

Selective mutism: Up to 60 mg/day with eventual taper based on 1 case series. Caution use due to drug & food interactions

1+ year: 6 mg/kg/day

1+ year: 8-10 mg/kg/day or 300 mg

1+ year: 8-10 mg/kg/day or 300 mg

1+ year: 8-10 mg/kg/day or 300 mg

Safety and efficacy have not been established

12+ years: 0.2 mg/kg or 10 mg 4+ years: under 30 kg: 14 mg/kg/day, if 30 kg or more: 10 mg/kg/day or 600 mg

8+ years: 2000 mg

60 mg

10+ years: 600 mg 5 - 10 years: 3 mg 11+ years: 6 mg 11+ years: 12-37.5 mg Q2 weeks

3200 mg

100 mg

12+ years: 12 mg patch daily

7+ years: 200 mg

7+ years: 20-30 kg: 6 g, 30-45 kg: 7.5 g, >45 kg: 9 g

2+ years: 50 mg/kg/day or 3000 mg

6+ years: 3 mg/kg/day

12+ years: 60 mg

12+ years: 32 mg

Seizure dosing

2-9 years: < 11 kg: 250 mg 12-22 kg: 300 mg 23-31 kg: 350 mg 32-38 kg: 350 mg

> 38 kg or 10+ years: 400 mg

16+ years: 60 mg/day 0-2 years: 100 mg, 3-5 years: 150 mg, 6+ years: 200 mg 6-12 years: 15 mg, 13+ years: 40 mg

12+ years: 100 mg

5+ years: 1000 mg

5+ years: 1000 mg

7+ years: 150 mg 1+ year: 10-15 kg: 1000 mg, 16-30 kg: 1500 mg, >30 kg: 3000 mg 7-11 years: 20 mg/day 12+ years: 30 mg/day

7+ years: 20 mg

5+ years: 160 mg

5+ years: 20 mg 0-15 years: 8 mg/kg/day, 16+ years: 600 mg

7 and under. The current recommendations were created by the ly. CAL ADVICE

es only and is not intended to be a substitute for professional medical h care provider with any questions you may have regarding a medical d the Psychotropic Medication Advisory Committee – Excessive

Trade Names Generic Name

Xanax, Xanax XR ALPRAZOLAM Elavil AMITRIPTYLINE HCL

Limbitrol, Limbitrol DS AMITRIPTYLINE/CHLORDIAZEPOXIDE

* Amytal AMOBARBITAL SODIUM

Asendin AMOXAPINE

Abilify ARIPIPRAZOLE

Aristada ARIPIPRAZOLE LAUROXIL

Nuvigil ARMODAFINIL Saphris ASENAPINE MALEATE

Strattera ATOMOXETINE HCL

Rexulti BREXPIPRAZOLE

* Briviact BRIVARACETAM

Aplenzin BUPROPION HBR

Wellbutrin SR, Wellbutrin XL, Forfivo XL, Zyban BUPROPION HCL Buspar BUSPIRONE HCL

* Tegretol, Tegretol XR, Equetro, Epitol CARBAMAZEPINE

Vraylar CARIPRAZINE HCL

Librium CHLORDIAZEPOXIDE HCL

Librax CHLORDIAZEPOXIDE/CLIDINIUM BR

Thorazine, Largactil, Ormazine CHLORPROMAZINE HCL

Celexa CITALOPRAM HYDROBROMIDE

Anafranil CLOMIPRAMINE HCL Klonopin CLONAZEPAM

Catapres, Kapvay CLONIDINE HCL

* Tranxene CLORAZEPATE DIPOTASSIUM

Clozaril, Fazaclo ODT, Versacloz CLOZAPINE Norpramin, Pertofrane DESIPRAMINE HCL

Pristiq DESVENLAFAXINE

Focalin, Focalin XR DEXMETHYLPHENIDATE HCL

Dexedrine DEXTROAMPHETAMINE SULFATE

Adderall, Adderall XR, Mydayis DEXTROAMPHETAMINE/AMPHETAMINE * Valium DIAZEPAM

Depakote, Depakote ER, Depakote * Sprinkles DIVALPROEX SODIUM

Silenor, Sinequan DOXEPIN HCL

Cymbalta DULOXETINE HCL

Cipralex, Lexapro ESCITALOPRAM OXALATE * Aptiom, Zebinix ESLICARBAZEPINE ACETATE

* Zarontin ETHOSUXIMIDE

* Peganone ETHOTOIN

* Trobalt, Potiga EZOGABINE

* Felbatol FELBAMATE

Prozac, Sarafem FLUOXETINE HCL

Permitil, Prolixin Deconaote (INJ) FLUPHENAZINE DECANOATE Prolixin Elixir, Modecate FLUPHENAZINE HCL

Luvox FLUVOXAMINE MALEATE

* Cerebyx (INJ) FOSPHENYTOIN SODIUM * Neurontin GABAPENTIN

* Horizant GABAPENTIN ENACARBIL

Tenex GUANFACINE HCL

Haldol HALOPERIDOL

Haldol Decanoate (AMP), Peridol, Haloperidol LA HALOPERIDOL DECANOATE

Haldol (AMP) HALOPERIDOL LACTATE

Fanapt, Zomaril ILOPERIDONE Tofranil IMIPRAMINE HCL

Tofranil-PM IMIPRAMINE PAMOATE

Marplan ISOCARBOXAZID

* Vimpat LACOSAMIDE

* Lamictal LAMOTRIGINE

* Keppra LEVETIRACETAM

Fetzima LEVOMILNACIPRAN HCL

Vyvanse LISDEXAMFETAMINE DIMESYLATE Eskalith CR, Lithobid LITHIUM CARBONATE

Lithium LITHIUM CITRATE

Ativan LORAZEPAM

Loxitane LOXAPINE

Loxitane LOXAPINE SUCCINATE

Latuda LURASIDONE HCL Ludiomil MAPROTILINE HCL

Miltown, Equanil MEPROBAMATE

Desoxyn, Methedrine METHAMPHETAMINE HCL

* Celontin METHSUXIMIDE

Ritalin, Ritalin LA, Concerta, Metadate CD, Methylin, Methylin ER, Quillivant XR, Quillichew ER, Aptensio XR, Cotemplat XR-ODT, Jornay PM, Adhansia XR, Daytrana (PTCH) METHYLPHENIDATE * Versed MIDAZOLAM

Remeron MIRTAZAPINE

Provigil MODAFINIL Moban MOLINDONE HCL Serzone, Dutonin, Nefadar NEFAZODONE HCL

Pamelor NORTRIPTYLINE HCL

Zyprexa OLANZAPINE

Symbyax OLANZAPINE/FLUOXETINE HCL

Serax, Alepam OXAZEPAM

* Trileptal, Oxtellar XR OXCARBAZEPINE Invega PALIPERIDONE

Invega Sustenna, Invega Trinza (INJ) PALIPERIDONE PALMITATE

Paxil, Paxil CR PAROXETINE HCL

Brisdelle, Pexeva PAROXETINE MESYLATE

* Nembutal (INJ) PENTOBARBITAL SODIUM

* Fycompa PERAMPANEL

Trilafon PERPHENAZINE

Etrafon, Triavil, Triptafen PERPHENAZINE/AMITRIPTYLINE HCL Nardil PHENELZINE SULFATE

* Solfoton PHENOBARBITAL

* Dilantin PHENYTOIN

* Dilantin PHENYTOIN SODIUM

* Dilantin PHENYTOIN SODIUM EXTENDED

* Nuplazid PIMAVANSERIN TARTRATE Orap PIMOZIDE

* Lyrica PREGABALIN

* Mysoline PRIMIDONE

Vivactil PROTRIPTYLINE HCL

Seroquel QUETIAPINE FUMARATE

Risperdal RISPERIDONE Risperdal Consta (INJ) RISPERIDONE MICROSPHERES

* Banzel RUFINAMIDE * Seconal Sodium SECOBARBITAL SODIUM

Emsam, Eldepryl, Zelapar SELEGILINE

Zoloft SERTRALINE HCL

Alcover, Gamma-OH, Natril, Oxybutyras, Kalceks, Somsanit, * Xyrem SODIUM OXYBATE

* Diacomit STIRIPENTOL

Mellaril THIORIDAZINE HCL Navane THIOTHIXENE

* Gabitril TIAGABINE HCL

* Topamax TOPIRAMATE

Parnate TRANYLCYPROMINE SULFATE

Desyrel, Desyrel Dividose, Oleptro, Trazodone D TRAZODONE HCL

Stelazine TRIFLUOPERAZINE HCL

Surmontil TRIMIPRAMINE MALEATE * Depakene, Stavzor, Depacon VALPROIC ACID

Convulex, Depakote, Epilim, Stavzor, * Valproate VALPROIC ACID (AS SODIUM SALT)

Effexor VENLAFAXINE HCL

* Sabril VIGABATRIN

Viibryd VILAZODONE HCL Trintellix, Brintellix VORTIOXETINE HYDROBROMIDE

Geodon ZIPRASIDONE HCL

Geodon ZIPRASIDONE MESYLATE (Injection)

* Zonegran ZONISAMIDE

* FDA approved dose or PMAC recommended dose is for/based on non-psychiatric indication

Last updated and approved+: 11/30/2020 + Children’s Division has implemented an Excessive Dosage Guide for children in foster care 17 Psychotropic Medication Advisory Committee (PMAC). Updates will be posted at least annuall

DISCLAIMER: THE CHILDREN'S DIVISION EXCESSIVE DOSAGE GUIDE DOES NOT PROVIDE MEDIC The information contained herein regarding Excessive Dosage Guide is for informational purpose advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healt condition or treatment. The Excessive Dosage Guide will be reviewed and updated by UMKC and Dosage Subcommittee. Official version of the Excessive Dosage Guide is maintained at the Department of Social Services website. Max Dosage FDA approval or PMAC recommendation

(IF DOSE EXCEEDS WHAT IS LISTED BELOW OR SAFETY AND EFFICACY HAVE NOT BEEN ESTABLISHED - REFERRAL TO CFE FDA Pediatric IS REQUIRED PRIOR TO CONSENT) Approved Indication

Safety and effectiveness of XANAX in individuals below 18 years of age have not been 7+ years: 3 mg established.

12+ years: 200 mg Depression

Not approved for use in 12+ years: 150 mg pediatric patients

6+ years: 500 mg/DOSE N/A Not approved for use in Safety and efficacy have not been established at this time pediatric patients

Schizophrenia, Bipolar , Irritability associated with 6-10 years: 15 mg autistic disorder, Tourette's 11+ years: 30 mg disorder

Safety and efficacy have not been established at this time N/A

Safety and efficacy have not been established at this time N/A Bipolar I disorder - Acute monotherapy treatment of manic or mixed episodes, in adults & pedicatric patients 10+ years: 20 mg 10-17 years of age 6+ years Attention Deficit Disorder Children < 70 kg: 1.4 mg/kg/day or 100 mg w/Hyperactivity

Safety and efficacy have not been established at this time N/A

BRIVIACT is indicated as : based on weight 4+ yo adjunctive therapy in the 11-20kg: 5 mg/kg treatment of partial-onset 20-50kg: 4 mg/kg 50kg or more: 200 mg in patients 16 years of age and older with 16 + yo: 200 mg .

6+ years: 300 mg N/A

Major Depressive Disorder (MDD) - Safety and effectiveness in the pediatric population have not been 6+ years: 300 mg established Generalized Anxiety Disorder 6+ years: 60 mg/day (GAD)

0-5 years: 35 mg/kg 6-12 years: 1 gm 13-14 years: 1 gm 15+: 1,200 mg Epilepsy, Trigeminal Neuralgi

Safety and efficacy have not been established at this time N/A Relief of withdrawal symptoms of acute alcoholism, for 6+ years: 30 mg parenteral form.

Safety and efficacy have not been established at this time N/A

Children 5-12 years: 200 mg oral, 40 mg IM , Psychoses, 13+ years: 500 mg oral, 75 mg IM Anxiety and Agitation

Depression; Safety and effectiveness in pediatric patients have not been 7+ years: 40 mg established.

OCD; Safety and effectiveness in the pediatric population other than pediatric patients with OCD 10+ years: 200 mg have not been established. 4 mg/day for psychiatric disorders N/A

Immediate Release 27-40.5kg: 0.2 mg/day Safety and effectiveness in 40.5-45kg: 0.3 mg/day pediatric patients have not if 45kg or more: 0.4 mg/day been established in adequate Extended Release: and well-controlled trials 6+ years: 0.4 mg/day (immediate release product). Because of lack of sufficient clinical experience, tablets are no recommended for use in 9-12 years: 60 mg/day patients less than 9 years of 13+ years: 90 mg/day age.

Safety and effectiveness in pediatric patients have not 6+ years: 400 mg been established. depression/ADHD. Consideration for drug use in child or adolescent must balance the potential risk with the clinical need (see 6 -12 years: 100 mg ADVERSE REACTIONS- 13+ years: 150 mg Cardiovascular).

100 mg N/A

6+ years: Immediate Release: 20 mg/day CNS stimulant indicated Extended Release: 30 mg/day for used to treat ADHD.

Amphetamines are not recommended for use in pediatric patients under 3 years of age with ADHD with 3+ years: 40 mg hyperactivity. Immediate Release 3+ years: 40 mg

Extended Release: 6+ years: 30 mg if 50kg or more: 60 mg

Mydayis: 25 mg Safety and effectiveness in pediatric patients below the age of 6 months have not 20 mg/day been established.

Pediatric patients under the age of two years are at a considerably increased risk of developing fatal hepatotoxicity, especially those with Divalproex sodium: the aforementioned condition 5+ years - 1000 mg s.

The use of doxepin children under 12 years of age is not 7 - 11 years: 3 mg/kg/day, recommended because safe 12+ years: 300 mg/day conditions for its use have not 150mg/single DOSE been established.

Decreased appetite and weight loss have been observed in association with the use of SSRIs and SNRIs. consequently, regular monitoring of weight and growth should be preformed in children and adolescents 7+ years: 120 mg treated with SNRIs.

Safety and effectiveness of Lexapro in pediatric patients less than 12 years of age has 6+ years: 20 mg not been established. 4-17 years

11-21kg: 600 mg 22-31kg: 800 mg 32-38kg: 900 mg if 38kg or more: 1,200 mg N/A

Safety and effectiveness in pediatric patients below the age of 3 years have not been 3+ years: 1,500 mg established.

Indicated for the control of tonic-clonic and complex 1+ years: 3 gm/day partial seizures.

Safety and efficacy have not been established N/A

The safety and effectiveness of Felbatol in children other than those with Lennox- Lennox-Gastaut 2+ years: Gastaut syndrome has not 45 mg/kg or 3,600 mg - whichever is less been established.

Safety and effectiveness in 8-11 years: 40 mg pediatric patients have not 12+ years: 60 mg been established.

Safety and efficacy have not been established N/A Doses studied up to 24 mg/day N/A 8 - 11 years: 200 mg; 12+ years: 300 mg OCD

The safety of fosphenytoin in pediatric patients has not 1,500 mg PE been established. Use of gabapentin as adjunctive therapy in the treatment of partial seizures in pediatric patients 3 3-4 years: 40 mg/kg to 12 is approved for Pfizer 5-12 years: 35 mg/kg inc.'s gabapentin. However 13+ years: 3,600 mg not labeled for pediatric use.

Safety and efficacy of extended-release products have not been established N/A

Immediate Release: 6+ years 27-40.5kg: 2 mg; 40.5-45kg: 3 mg; ADHD; Safety 45kg or more: 4 mg and efficiency of INTUNIV in Extended Release: pediatric patients less than 6 Children 6 to 12 years: 4 mg/day; years of age have not been Adolescents: 13 to 17 years: 7 mg/day. established.

Safety and effectiveness in pediatric patients have not 3+ years: 15 mg/day been established.

Safety and efficacy have not been established N/A

Safety and effectiveness in pediatric patients have not 3+ years: 15 mg/day been established.

Safety and efficacy have not been established N/A Depression & childhood Enuresis. a dose of 2.5 mg/kg/day of Tofranil should not be exceeded in childhood. ECG charges of unknown significance have been 8-12 years: 50 mg reported in pediatric patients 13+ years: 100 mg with does twice this amount.

Endogenous depression; Tofranil-PM should not be used in children because of the increased potential for acute overdosage due to the 8+ years: 100 mg high unit . 0-15 years: safety and efficacy have not been established

16+ years: 60 mg/day N/A

Partial-onset seizures; The safety and effectiveness of Vimpat in pediatric patients <17 years have not been 13+ years: 400 mg established.

Epilepsy; adjunctive therapy in patients age 2 years and older for partial-onset 2+ years: 200 mg seizures.

Treatment of partial onset of seizures; Safety and effectiveness in patients 1 month - 4 years: 50 mg/kg/day below the age of 16 have not 4+ years: 3000 mg been established.

Safety and efficacy have not been established N/A

Vyvanse is indicted for use in children aged 6-12 years. Under 6 years of age 6+ years: 70 mg are not recommended. Treatment for ; Lithium has not been established in pediatric 7-12 years: 900 mg/day patients less than 7 years of 13+ years: 1200 mg/day age with bipolar I disorder.

Treatment of acute manic and mixed episodes in patients 7 years and older; Lithium as not been established in pediatric patients less than 7 7-12 years: 24 mEq/day years of age with bipolar I 13+ years: 32 mEq/day disorder.

2 mg single dose max 6 mg/day total Anxiety

Safety and efficacy have not been established N/A

Safety and efficacy have not been established N/A Schizophrenia; Safety and effectiveness in pediatric patients have not been 10+ years: 80 mg established. Safety and efficacy have not been established N/A

Nervousness or tension; Pediatric patients less than 16 years of age have 6+ years: 600 mg not been established. Attention Deficit Disorder 6+ years: 25 mg w/Hyperactivity Control of absence (petit mal) seizures that are refractory to 1200 mg/day other drugs

2 mg/kg or 60 mg,

Concerta 54 mg (age 6-12),

Concerta 72 (age 13+),

Contempla XR ODT 51.8 mg, ADD, Narcolepsy; 6 years and over; Daily dosage above Jornay PM 100 mg, 60mg is not recommended. The safety and efficacy of midazolam for sedation/anxiolysis/amnesia following single dose intramuscular administration, intravenously by intermittent injections and continuous infusion have 0-5 years: 6 mg been established in pediatric 6+ years: 10 mg and neonatal patients.

30 mg N/A Narcolepsy; Safety and effectiveness in individuals if under 30 kg: 200 mg below 16 years of age have if 30kg or more: 300 mg not been established. 12+ years: 225 mg Schizophrenia

Safety and efficacy have not been established N/A Not approved for use in 6+ years: 100 mg pediatric patients Bipolar I disorder, Schizophrenia, Depressive Episodes, 6+ years: 20 mg Agitation

Bipolar I, Schizophrenia, depressive Episodes, Agitation; Safety and effectiveness of Zyprexa and fluoxetine in combination in children <10 years of age have not been 10+ years: 12mg/50mg established.

Anxiety;Safety and effectiveness in pediatric patients under 6 years of age have not been established. Absolute dosage of pediatric patients 6 to 12 years of age 12+ years: 120 mg is not established.

Partial seizures in children 60 mg/kg/day 2-4 years: aged 4 and above with 5+ years max dose by weight: epilepsy; and as adjunctive 20-29 kg: 900 mg therapy in children aged 4 29.1-39 kg: 1200 mg years and above with 39 kg or more: 1800 mg epilepsy. Schizophrenia; Safety and effectiveness in patients <18 years of age have not been 12+ years: 12 mg established.

7+ years Based on literature review: 234 mg monthly

Monitor closely for side effects N/A

SSRI; Safety and effectiveness in the pediatric population 7+ years: 60 mg have not been established.

SSRI; Safety and effectiveness in the pediatric population 7+ years: 60 mg have not been established.

100 mg Seizures, Induce sleep Partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy age 12 4+ years: 12 mg years and older.

Management of the manifestations of psychotic disorders; control of 12+ years: 32 mg N/V in adults.

< 12 years: Safety and efficacy have not been established

12+ years outpatient: Amitriptyline max dose: 150 mg/day PO Perphenazine max dose: 24 mg/day PO (up to 64 mg/day for short periods) N/A Safety and efficacy have not been established

Selective mutism: Up to 60 mg/day with eventual taper based on 1 case series. Caution use due to drug & food interactions N/A

1+ year: 6 mg/kg/day Depression, .

Generalized Tonic- clonic status epileptics and prevention and treatment of seizures occurring during neurosurgery. Review loading 1+ year: 8-10 mg/kg/day or 300 mg dose for pediatrics.

Generalized Tonic- clonic status epileptics and prevention and treatment of seizures occurring during neurosurgery. Review loading 1+ year: 8-10 mg/kg/day or 300 mg dose for pediatrics.

Generalized Tonic- clonic status epileptics and prevention and treatment of seizures occurring during neurosurgery. Review loading 1+ year: 8-10 mg/kg/day or 300 mg dose for pediatrics.

Safety and efficacy have not been established N/A Used for suppression of motor and phonic tics in patients with Tourette's disorder. Use and efficacy of ORAP in patients less than 12 years of age is 12+ years: 0.2 mg/kg or 10 mg limited.

DPN, PHN, adjunctive therapy for the treatment of partial- onset seizures in patients 1 month of age and older, 4+ years: Fibromyalgia, Neuropathic under 30 kg: 14 mg/kg/day, pain associated with spinal if 30 kg or more: 10 mg/kg/day or 600 mg cord injury.

Seizures; for children under 8 years of age is 10 to 25mg/kg/day in divided 8+ years: 2000 mg doses.

Mental depression; Safety and effectiveness in the pediatric population have not 60 mg been established. Schizophrenia, Bipolar I disorder Manic episodes, Bipolar disorder depressive 10+ years: 600 mg episodes

Antipsychotic indicated for schizophrenia, Irritability 5 - 10 years: 3 mg associated with autistic 11+ years: 6 mg disorder, Bipolar I disorder 11+ years: 12-37.5 mg Q2 weeks N/A Seizures associated with Lennox-Gastaut Syndrome in pediatric patients 1 year of 3200 mg age and older. 100 mg N/A

12+ years: 12 mg patch daily N/A

SSRI used to treat MDD, OCD, PD, PTSD, SAD, PMDD; Established in treatment of OCD in pediatric patients aged 7+ years: 200 mg 6-17.

7+ years: 20-30 kg: 6 g, Pediatric patients under the 30-45 kg: 7.5 g, age of 18 years have not been >45 kg: 9 g studied. Seizures associated with Dravet Syndrome in patients 2 years of age and older 2+ years: 50 mg/kg/day or 3000 mg taking .

Depression, Anxiety, Agitation, tension, sleep disturbance; Not 6+ years: 3 mg/kg/day intended for children under 2 Schizophrenia; children age 12+ years: 60 mg 12 and older. Treat partial seizures in adults and children age 12 and 12+ years: 32 mg older. dosing

2-9 years: < 11 kg: 250 mg 12-22 kg: 300 mg 23-31 kg: 350 mg Epilepsy or seizures 32-38 kg: 350 mg associated with Lennox- Gastaut syndrome in patients > 38 kg or 10+ years: 400 mg 2 years of age and older.

16+ years: 60 mg/day N/A

MDD; Safety and 0-2 years: 100 mg, effectiveness in the pediatric 3-5 years: 150 mg, population have not been 6+ years: 200 mg established.

Schizophrenia; Dosage should be adjusted to the weight of the child and severity of the symptoms. The dosage are for children, ages 6-12, who 6-12 years: 15 mg, are hospitalized or under 13+ years: 40 mg close supervision.

Depression; Safety and effectiveness in the pediatric population have not been 12+ years: 100 mg established. Treatment of simple and complex absence seizures, and adjectively in patients with multiple seizure types which include absence 5+ years: 1000 mg seizures ages 2 and up.

Treatment of simple and complex absence seizures, and adjectively in patients with multiple seizure types which include absence 5+ years: 1000 mg seizures ages 2 and up.

MDD; Safety and effectiveness in the pediatric population have not been 7+ years: 150 mg established.

Refractory Complex Partial Seizures in Adults; The safety 1+ year: and efficacy of SABRIL in 10-15 kg: 1000 mg, pediatric patients < 16 years 16-30 kg: 1500 mg, of age with CPS has not been >30 kg: 3000 mg established.

7-11 years: 20 mg/day 12+ years: 30 mg/day N/A 7+ years: 20 mg N/A

The safety and effectiveness of Ziprasidone in pediatric patients have not been 5+ years: 160 mg established.

The safety and effectiveness of Ziprasidone in pediatric patients have not been 5+ years: 20 mg established.

Adjunctive therapy in the treatment of partial seizures in adults with 0-15 years: 8 mg/kg/day, epilepsy. Used for children 16 16+ years: 600 mg and older.

7 and under. The current recommendations were created by the ly.

CAL ADVICE es only and is not intended to be a substitute for professional medical h care provider with any questions you may have regarding a medical d the Psychotropic Medication Advisory Committee – Excessive

Youngest Age With Dosing Recommendations FDA Adult Approved Dose FDA Pediatric Approved Dose (Not all FDA (per day unless noted) (per day unless noted) Approved)

4mg 7-18 yo: 0.06mg/kg/day 7 yo 300mg 200 mg 12 yo

150mg amitrip./60mg chlordi. N/A

1gm/DOSE 500mg/DOSE 6 yo 400mg - outpatient 600mg - hospitalized N/A N/A

Autism - 6-17: 15mg 30 mg Bipolar 10-17yo: 30mg 6

882 mg per month N/A N/A

250 mg N/A N/A 20 mg 20 mg 10 yo

100mg Children < 70 kg: 1.4 mg/kg/day or 100 mg 6 yo

4 mg N/A N/A

4+ yo: 11-20kg: 5mg/kg 20-50kg: 4mg/kg 50+ kg: 200mg 200 mg 16 + yo: 200mg 4 yo

522 mg N/A N/A

450 mg smoking cessation: 300mg 6mg/kg (300mg) 6 yo 60 mg some clinical trials say up to 50mg/day in 5+ yo 5 yo

<6 yo: 35mg/kg 6-12yo: 1gm 12-15: 1gm 1600 mg 15+: 1,200 mg Non-specific

6 mg N/A N/A

300 mg/day 30mg 6 yo

2 caps 4 times per day N/A N/A 6+ MONTHS: and adolescents <45.5kg: 500mg (oral) <5yo and <22.7kg: IVIM - 40mg 5+ yo and 22.7-45.5kg: 75mg 800 mg >45.5kg: 800mg 6 MONTHS

40 mg (20mg if <60 yo) 40 mg 7 yo

250 mg 200 mg 10 yo 4 mg 20 mg for seizures 6 mg for tremors N/A N/A

0.6 mg N/A 6 yo

9-12yo: 60mg/day 90 mg/day >12: 90mg/day 9 yo

900 mg 400 mg 6 yo ADHD: 5+ yo: no max, 7-13yo: 100mg/day Depression: 6-12: 5mg/kg/day, adolescents 300 mg/day 150mg/day 5 yo

Up to 400 mg Studied N/A N/A

IR: 20mgday ER: 40mg/day >6yo: IR 20mg/day ER: 30mg/day 6 yo

60 mg IR: not listed 40 mg 3 yo for IR

IR- 3-5yo: 40mg; 6+: 40 mg ER: 6-12: 30mg (>50kg: 60mg); 13-17: 20mg IADHD: (>50kg: 60mg) IR: 40mg; ER: 60mg; triple- Mydayis: 25mg bead: 50mg 3 yo for IR generally 40-60mg/day Rectal gel: 20mg/DOSE; IV: 10mg/DOSE (5+yo) 6 MONTHS

Divalproex sodium: 5+ yo - 1000 mg 5 yo 60 mg/kg/day ER: 10yo

7 - 11 yo: 3 mg/kg/day, >12 yo 300mg/day 300 mg/day - Insomnia: 6 mg 150mg/DOSE 7 yo

120 mg 120mg 7 yo

30mg 20mg 6 yo No max listed 4 yo

>1,500mg should be 1,500mg (3+ yo) monitored 2 yo

No max; up to 2-3gm/day 3gm/day 1 yo

1200 mg N/A

14 yo Lennox-Gastaut 2-14yo: 45mg/kg or 3,600mg - 2 yo - Lennox- Not specified - up to 3,600mg whichever is less Gastaut

80mg 7 yo

100mg N/A N/A 40mg N/A

300mg

No max, use caution with >600mg PE/day Non-specific 3.6gm 3 yo

>1200mg no added benefit N/A N/A IR: 6+ yo (27-40.5kg: 2mg; 40.5-45kg: 3mg; >45kg: 4mg)

Monotherapy: Children 6 to 12 years: 4 mg/day; Adolescents: 13 to 17 years: 7 mg/day. Adjunct therapy (with psychostimulants): 4 No max lsited, ADR after 3mg mg/day. 6 yo

100 mg 3 yo

450 mg N/A N/A

30 mg 3 yo

24 mg N/A N/A 300 mg 2.5 mg/kg or 100 mg 8 y o

300 mg 2.5 mg/kg or 100 mg 8 y o

60 mg N/A

600 mg Adolescents 400 mg N/A

600 mg 200 mg 2 yo

3000 mg 3000 mg > 1 month

120 mg N/A

70 mg 70 mg 6 yo <23 kg: 900 mg, >23 kg: 40 mg/kg/day up to 1800 mg 1500 mg 7 yo, ER 12 yo

48 mEq not reported, up to 40 mEq 7 yo

10 mg 2 mg/dose N/A

250 mg N/A N/A

10 mg N/A N/A

160 mg 80 mg 10 yo 225 mg N/A N/A

2400 mg 600 mg 6 yo

60 mg 25 mg 6 yo

1200 mg 30 mg/kg/day or 1200 mg

60 mg, Concerta 72 mg, 2 mg/kg or 60 mg, Concerta 54 mg (age 6-12), Jornay PM & Adhansia XR Concerta 72 (adolescent), Contempla XR ODT 100 mg 51.8 mg, Jornay PM 100 mg, 3 yo 0.6 mg/kg 6 mg if < 5 yo, 10 if 6-16 yo 1 month

45 mg N/A N/A

400 mg 340 mg if < 30kg, 425 mg if > 30 kg 6 yo 225 mg 225 mg 12 yo 600 mg N/A N/A

150 mg 2 mg/kg or 100 mg 6 yo

30 mg 20 mg 6 yo

18mg/75mg 12mg/50mg 10 yo

120 mg 120 mg 12 yo

60 mg/kg/day age 2-4, For age 4-16 max dose by weight: 900 mg if 20-29 kg, 1200 mg if 29.1- 2400 mg 39 kg, and 1800 mg if > 39 kg 2 yo 12 mg 12 mg 12 yo

234 mg monthly N/A N/A

60 mg IR, 75 mg ER 60 mg 7 yo

60 mg 60 mg 7 yo

500 mg 100 mg

12 mg 12 mg 4 yo

64 mg 32 mg 12 yo

200mg/16mg N/A N/A 90 mg N/A N/A

300 mg 6 mg/kg/day Infants

600 mg 8-10 mg/kg/day or 300 mg Infants

600 mg 8-10 mg/kg/day or 300 mg Infants

600 mg 8-10 mg/kg/day or 300 mg Infants

34 mg N/A N/A 10 mg 0.2 mg/kg or 10 mg 12 yo

<30 kg: 14 mg/kg/day, 600 mg if >30 kg: 10 mg/kg/day or 600 mg 4

2000 mg 2000 mg 8 yo

60 mg 60 mg

800 mg 800 mg 10 yo

8 mg 6 mg 5 yo 50 mg every 2 weeks N/A N/A

3200 mg 3200 mg no longer used no longer used N/A

12 mg patch N/A 17 yo

200 mg OCD: 200 mg 6 yo

20-30 kg: 6 g, 30-45 kg: 7.5 g, 9 g >45 kg: 9 g 7 yo

3000 mg 50 mg/kg/day or 3000 mg 2 yo

800 mg 3 mg/kg/day 6 yo 60 mg 60 mg 12 yo

56 mg 32 mg 12 yo

400 mg 9 mg/kg/day Infants

60 mg N/A N/A

600 mg < 3yo: 100 mg, 3-5 yo: 150 mg, > 5 yo: 200 mg 18 months

6-12 yo: 15 mg, 50 mg > 12 yo: 40 mg 6 yo

300 mg 100 mg adolescents 60 mg/kg/day >5 yo: 1000 mg 5 yo

60 mg/kg/day >5 yo: 1000 mg 5 yo

XR: 225 mg, IR: 375 mg 150 mg 7 yo

Infants: 150 mg/kg/day, 10-15 kg: 1000 mg, 16-30 kg: 1500 mg, 3000 mg >30 kg: 3000 mg Infants

40 mg N/A N/A 20 mg N/A N/A

160 mg <45 kg: 80 mg, >45 kg: 160 mg 5 yo

40 mg 20 mg 5 yo

600 mg < 16 yo: 8 mg/kg/day, > 16 yo: 600 mg Infants

PMAC Reviewed Dosage for Medications Link to Without FDA Pediatric Approved Dose Package Insert Other Resources/information

Wolters Kluwer Clinical Drug Information, Inc. (Lexi-Drugs). Wolters Kluwer Clinical Drug Information, Inc.; accessed > 7 years: 3 mg 7/30/2020

Safety and efficacy have not been established for the combination https://www.accessdata.fda.go medication at this time v/drugsatfda_docs/label/2014/ 085966s095,085969s084,0859 Max amitriptyline dose in > 12 years: 68s096,085971s075,085967s0 150 mg/day PO in outpatients 76,085970s072lbl.pdf

Safety and efficacy have not been established at this time

6-10 years: 15 mg > 10 years: 30 mg Safety and efficacy have not been established at this time < 17 years: Safety and efficacy have not been established at this time

> 17 years: 250 mg/day for narcolepsy and OSA/HS 150 mg/day for circadian rhythm disruption Safety and efficacy have not been established at this time

https://www.a ccessdata.fda.g ov/drugsatfda_ docs/label/201 6/205836Orig1 s000,205837Or ig1s000,20583 8Orig1s000lbl. pdf

Safety and efficacy have not been established for extended release tablets or for patients < 6 years Oh DA et al. Single-dose pharmacokinetics of bupropion > 6 years: hydrobromide and metabolites IR max dose: 300 mg/day PO for ADHD in healthy adolescent and adult SR max dose: 6 mg/kg/day (300-400 subjects. Clin Pharmacol Drug mg/day) PO for depression Dev. 2015;4(5):346-53

https://dailym ed.nlm.nih.gov /dailymed/fda/ fdaDrugXsl.cfm ?setid=cbc8c07 4-f080-4489- a5ae- 207b5fadeba3 &type=display https://dailym ed.nlm.nih.gov /dailymed/fda/ fdaDrugXsl.cfm ?setid=33999f 17-f689-40a1- 955a- fb19c0590e0e > 5 years: 60 mg/day &type=display

https://www.a ccessdata.fda.g ov/drugsatfda_ docs/label/200 9/016608s101, 018281s048lbl. pdf Szatmari B et al. Cariprazine Safety and efficacy have not been Safety in Adolescents and the established at this time Elderly: Analyses of Clinical Study Data. Front Psychiatry. 1 study recommended a max dose of 6 mg 2020

Safety and efficacy have not been established at this time

Dopheide JA. Am J Health Syst https://www.a Pharm. 2006 ccessdata.fda.g Wolters Kluwer Clinical Drug ov/drugsatfda_ Information, Inc. (Lexi-Drugs). docs/label/201 Wolters Kluwer Clinical Drug 9/020822s051l Information, Inc.; accessed bl.pdf 7/30/2020 4 mg/day for psychiatric disorders Neuroirritability, agitation (palliative care) < 30 kg Max daily dose: 0.2 mg/kg/day in 3 doses > 30 kg Max daily dose: 20 mg/day

Seizures < 10 years or < 30 kg Max initial dose: 0.05 mg/kg/day Max daily dose: 0.2 mg/kg/day > 10 years or > 30 kg Max initial dose 0.5 mg/dose 3 times daily Max daily dose: 20 mg/day

Panic Disorder > 18 years Max dose: 4 mg/day

Immediate Release 27-40.5kg: 0.2mg/day 40.5-45kg: 0.3mg/day Wolters Kluwer Clinical Drug >45kg: 0.4mg/day Information, Inc. (Lexi-Drugs). Wolters Kluwer Clinical Drug Extended Release: Information, Inc.; accessed >6yo: 0.4mg/day 7/30/2020 6 -12 years: 100 mg > 12 years: 150 mg

Findling RL et al. Safety and tolerability of desvenlafaxine in children and adolescents with major depressive disorder. J Child Adolesc Psychopharmacol. Safety and efficacy have not been 2014;24(4):201–209 established with RCTs Atkinson Set al. Desvenlafaxine Versus Placebo in the Most studies with desvenlafaxine maxed Treatment of Children and the dose at 50 mg/day Adolescents with Major Depressive Disorder. J Child One study went up to 100 mg/day in Adolesc Psychopharmacol. children and 200 mg/day in adolescents 2018;28(1):55–65

Wolters Kluwer Clinical Drug Information, Inc. (Lexi-Drugs). Wolters Kluwer Clinical Drug 4-17yo11-21kg: 600mg Information, Inc.; accessed 22-31kg: 800mg 7/30/2020 32-38kg: 900mg >38kg: 1,200mg https://pubmed.ncbi.nlm.nih.g >18yo: 1,600mg ov/29898974/

2+ yo: 60mg/kg/day or 2gm - whichever is less

Safety and efficacy have not been established

12-18 yo: 60mg 8-11 yo: 40 mg J Child Adolesc Psychopharmacol. Safety and efficacy have not been 2017;27(1):2-9 established https://pubmed.ncbi.nlm.nih.g 1 study used a max dose of 6.25 mg ov/28112539/ Doses studied up to 24mg/day

8 - 11 yo: 200 mg; Adolescents: 300 mg

1,500mg PE 3-4yo: 40mg/kg 5-12yo: 35mg/kg >12yo: 3,600mg

Safety and efficacy of extended-release products have not been established https://clinicaltrials.gov/ct2/sh No max dose recommended at this time ow/NCT02560766?term=GABA (recruiting trials will use a max dose of PENTIN+ENACARBIL&age=0&d 600 mg/day) raw=2&rank=4

Wolters Kluwer Clinical Drug Information, Inc. (Lexi-Drugs). Wolters Kluwer Clinical Drug Information, Inc.; accessed 7/30/2020

15 mg Safety and efficacy have not been established

Based on 1 case report, use of 100 mg https://www.sciencedirect.co every month was safe and effective in an m/science/article/pii/S089085 11 year old boy 6709603270?via%3Dihub

15 mg

Safety and efficacy have not been established

No recommended max dose at this time 8-12 years: 50 mg > 13 years: 100 mg

>8 years: 100 mg >16 years: 60 mg/day < 16 years safety and efficacy have not been established

1 month - 4 years: 50mg/kg/day > 4 years: 3000 mg Safety and efficacy have not been established 7-12 years: 900 mg/day >12 years: 1200 mg/day

7-12 years: 24 mEq/day >12 years: 32 mEq/day 2 mg single dose max 6 mg/day total Safety and efficacy have not been established

Literature suggests a max of 15 mg/day PO in adolescent patients off-label for irritability related to autism as add-on therapy (8 – 52 years)

Hellings JA et al. Low dose Clinical safety and efficacy have not been loxapine: neuromotor side established (no clinical trials at this time). effects and tolerability in autism spectrum disorders. J 2 PK studies used 2.5 or 5 mg/day if their Child Adole Psychopharm. body weight was < 50 kg and 5 or 10 2015;25:628-624. mg/day if body weight > 50 kg Safety and efficacy have not been established

1 case report of maprotiline use in children with enuresis and behavioral disorders used a max of 75 mg (median age 9)

There has been 1 case report of a 6 year old trial having tonic-clonic seizures, generalized confulsions, and neurologic Simeon J et al. Prog impairment at a dose of 12 mg/kg (child Neuropsychopharmacol. weight not listed) 1981;5(5-6):495-8.

1200 mg/day < 5 years: 6 mg 6-16 years: 10 mg

30 mg: Based on literature review, can use up to 45 mg/day in child and adolescents. Younger patients ages < 12 years used lower doses of 15-22 mg/day. Older patients > 12 years used higher doses of 30-45 mg/day

When using for MDD, may consider using higher doses of 30-45 mg/day and monitor closely for ADRs https://hhs.texas.gov/sites/def When using as adjunctive for other ault/files/documents/doing- indications (ADHD, social phobia, ASD, business-with-hhs/provider- chronic cyclic vomiting syndrome) may portal/facilities- consider using lower doses of 7.5-15 regulation/psychiatric/psychiat mg/day and slowly increase. ric-drug-formulary.pdf Children: < 7 years: safety and efficacy have not been established Wilens TE et al. Case study: nefazodone for juvenile mood 7-11 years: 300 mg/day (limited data disorders. J Am Acad Child available) Adolesc Psychiatry. 1997;36(4):481-5 Adolescents: Findling et al. Nefazodone 600 mg/day in depressed children and adolescents. J Am Literature review agrees with above Acad Child Adolesc Psychiatry. recommendation 2000;39(8):1008-16 > 7 years Based on literature review: 234 mg monthly

Monitor closely for side effects

< 12 years: Safety and efficacy have not been established

> 12 years outpatient: Amitriptyline max dose: 150 mg/day PO Perphenazine max dose: 24 mg/day PO (up to 64 mg/day for short periods) Safety and efficacy have not been established

Selective mutism: Up to 60 mg/day with eventual taper based on 1 case series. Caution use due to drug & food https://pubmed.ncbi.nlm.nih.g interactions ov/26560144/

Safety and efficacy have not been established 5 - 10 years: 3 mg > 10 years: 6 mg > 11 years: Max used in Indiana study: 12-37.5 mg Q2 weeks

Used caution < 11 years as there is not a lot of literature in this patient population. In the Indiana study, they used 12.5 – 25 mg Q2 weeks J Child Adolesc Psychopharmacol. > 17 years: 2017;27(1):2-9 Max used in Indiana study: 50 mg Q 2 https://pubmed.ncbi.nlm.nih.g weeks ov/28112539/

DelBello MP et al. A Double- Blind, Placebo-Controlled Study of Selegiline Transdermal System in Depressed < 12 years: patch is contraindicated. Safety and efficacy have not been Adolescents. J Child Adolesc established at this time. Psychopharmacol. 2014;24(6): > 12 years: 12 mg patch daily 311–317

Depression and Anxiety Disorders: 200 mg Seizure dosing 2-9 years: < 11 kg: 250 mg 12-22 kg: 300 mg 23-31 kg: 350 mg 32-38 kg: 350 mg > 38 kg or > 10 years: 400 mg Per package insert: > 16 years: 60 mg/day PO < 16 years: safety and efficacy have not been established Durgam S et al. A Phase 3, Based on literature review: Double-Blind, Randomized, Use caution Placebo-Controlled Study of Vilazodone in Adolescents with > 12 years: 30 mg/day Major Depressive Disorder. 7-11 years: 20 mg/day Paediatr Drugs. 2018; 20(4): < 6 years: avoid use 353–363 Findling RL et al. Pharmacokinetics and Safety of Vortioxetine in Pediatric Patients. J Child Adolesc Psychopharmacol. 2017 Aug 1; Based on literature review: 27(6): 526–534 Findling RL et al. A 6-Month > 7 years: limited data using up to 20 Open-Label Extension Study of mg/day. Current literature gives no Vortioxetine in Pediatric supportive recommendation but gives Patients with Depressive or recommended doses for future studies Anxiety Disorders. J Child Adolesc Psychopharmacol. < 7 years: avoid use (no data) 2018 Feb 1; 28(1): 47–54 The literature reviewed by the PMAC cited below:

1. Pediatric 2. Pediatric Psychopharm Dose Psychopharm Dose Re comme nda t ions Re comme nda t ions

Last updated and approved+: 11/30/2020 + Children’s Division has implemented an Excessive Dosage Guide for children in foster care 17 and under. The current recommendations were created by the Psychotropic Medication Advisory Committee (PMAC). Updates will be posted at least annually.

DISCLAIMER: THE CHILDREN'S DIVISION EXCESSIVE DOSAGE GUIDE DOES NOT PROVIDE MEDICAL ADVIC

The information contained herein regarding Excessive Dosage Guide is for informational purposes only and be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your phy qualified health care provider with any questions you may have regarding a medical condition or treatmen Dosage Guide will be reviewed and updated by UMKC and the Psychotropic Medication Advisory Committe Dosage Subcommittee. Official version of the Excessive Dosage Guide is maintained at the Department of Social Services website.

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d is not intended to ysician or other nt. The Excessive ee – Excessive

Abbreviations/ Symbols Definition ADR adverse drug reaction < less than > greater than ≤ less than or equal to ≥ greater than or equal to A.M. morning ac before meals achs before meals and at bedtime AD right ear ADHD attention deficit hyperactivity disorder Adolescent age 13 - 17 AS Left ear ASD autism spectrum disorder AU both ears BID twice a day D/C, dc, disc Discontinue DOSE amount of drug taken at a particular time EC Enteric-coated gm gram gtt, gtts drop, drops HS at bed time hx history ID Intradermal INJ injection IR Immediate release IV/IM intravenous/intramuscular kg kilogram mcg microgram MDD major depressive disorder mEq milliequivalent mg milligram NPO nothing by mouth OCD obsessive -compulsive disorder OD, o.d., right eye OM otitis media OS, o.s. left eye OSA/HS Obstructive Sleep Apnea Hypopnea Syndrome OTC other the counter OU, o.u. both eyes PD personality disorder PE Phenytoin sodium equivalents PMDD premenstrual dysphoric disorder PO By mouth PRN as needed PTSD post traumatic stress disorder q every Q2 every 2 qd every day QID four times a day QOD every other day RCT Randomized controlled trial SAD seasonal affective disorder selective mutism complex childhood anxiety disorder SR sustained release SSRI selective stat immediately TID three times a day u unit XR, XL, XT extended release YO years old yr year HOW TO CALCULATE WEIGHT BASED DRUGS

To use the attached hyperlinks, kg to lb conversion link please single click on the link to be directed to the website lb to kg conversion link

Dosage Calculator mg/kg

Last updated and approved+: 11/30/2020 + Children’s Division has implemented an Excessive Dosage Guide for children in foster care 17 and under. The current recommendations were created by the Psychotropic Medication Advisory Committee (PMAC). Updates will be posted at least annually.

DISCLAIMER: THE CHILDREN'S DIVISION EXCESSIVE DOSAGE GUIDE DOES NOT PROVIDE MEDICAL ADVICE The information contained herein regarding Excessive Dosage Guide is for informational purposes only and is substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician o health care provider with any questions you may have regarding a medical condition or treatment. The Exces will be reviewed and updated by UMKC and the Psychotropic Medication Advisory Committee – Excessive Do Official version of the Excessive Dosage Guide is maintained at the Department of Social Services website.

s not intended to be a or other qualified ssive Dosage Guide osage Subcommittee.