PSYCHOTROPIC MEDICATION LIST ABOUT THIS …

1 PSYCHOTROPIC MEDICATION List Page 1 PSYCHOTROPIC MEDICATION LIST ABOUT this LIST DOSING this list presents PSYCHOTROPIC medications, recommended starting and maximum dosages, FDA approved indications, and common adverse effects. Not all medications prescribed by clinicians for psychiatric diagnoses in children and adolescents are included. It is important to consider that the long term effects of psychoactive medications are not fully understood, giving reason for special caution in prescribing these medications to children and adolescents with developing brains and nervous systems.

2 Psychoactive medications can be of significant benefit, but it is important to balance the potential risks of treatment against the risks of untreated illness. The list is intended to reflect usual doses and brief MEDICATION information. The list is not intended to serve as comprehensive drug information references or a substitute for sound clinical judgment in the care of individual patients, and individual patient circumstances should dictate care. Careful documentation of the rationale for decisions regarding PSYCHOTROPIC medications should occur, and careful monitoring and documentation of response to treatment should be observed.

3 Recommended dosages are intended to serve only as a guide for clinicians. Recommended doses and maximums are literature based, and do not necessarily represent FDA approved dosages. PILL SPLITTING Please note, clinicians sometimes split pills for dosing flexibility and cost savings. In general, extended release or long-acting medications and pills with coatings cannot safely be split. Typcially pills taken only once a day work best for splitting. ADVERSE EFFECTS Adverse effects listed for each MEDICATION are representative of the most common and/or serious side effects of the MEDICATION but is not intended to serve as a comprehensive review of all adverse effects for that MEDICATION .

4 Clinicians should consult package inserts for a full review. KEY Medications listed with an asterisk (*) indicate that a generic version is available. PSYCHOTROPIC MEDICATION List Page 2 MEDICATION Name Age Group Recommended Initial Dosage/Day Recommended Maximum Dosages/Day Schedule FDA Approved Indications Second Generation (Atypical) Antipsychotics Aripiprazole* Abilify Abilify Discmelt Abilify Maintena Children 6 and Up 2 mg 15 mg Once Daily Schizophrenia (Ages 13-17) Acute treatment of manic or mixed episodes associated with bipolar I disorder (Ages 10-17) Irritability associated with autistic disorder (Ages 6-17)

5 Adolescents 5 mg 30 mg Adverse Effects: Akathisia, anxiety, blurred vision, constipation, dizziness, extrapyramidal signs, fatigue, headache, insomnia, restlessness, sedation, tremor, vomiting, weight gain, cardiorespiratory arrest or failure, myocardial infarction, cerebrovascular accident, transient ischemic attack, cardiac arrhythmias, diabetic ketoacidosis, pancreatitis, agranulocytosis, leukopenia, neutropenia, rhabdomyolysis, seizure, tardive dyskinesia, suicidal behavior, angioedema, elevated body temperature.

6 Neuroleptic malignant syndrome Asenapine* Sapharis No pediatric data available Twice Daily None for Children Approved adult dosing 10 mg 20 mg Adverse Effects: Akathisia, dizziness, extrapyramidal signs, hypoesthesia, somnolence, weight gain, cardiac arrhythmia, hypersensitivity reaction, angioedema, neuroleptic malignant syndrome Clozapine* Clozaril FazaClo Children 6 and Up mg 150-300 mg Once to Twice Daily None for Children Adolescents mg 200-600 mg Adverse Effects: Constipation, dizziness, fever, headache, hypotension, nausea, sedation/somnolence, sweating, syncope, tachycardia, tremor, vertigo, visual disturbance, xerostomia, agranulocytosis, cardiac arrest, cardiac arrhythmia, cardiomyopathy, diabetes mellitus, diabetic ketoacidosis, eosinophilia, erythema multiforme, gastrointestinal hypomotility, glaucoma closed angle, hyperglycemia, myocarditis, neuroleptic malignant syndrome, pneumonia, pulmonary embolism, respiratory arrest.

7 Stevens-Johnson syndrome PSYCHOTROPIC MEDICATION List Page 3 MEDICATION Name Age Group Recommended Initial Dosage/Day Recommended Maximum Dosages/Day Schedule FDA Approved Indications Second Generation (Atypical) Antipsychotics Iloperidone* Fanapt No pediatric data available Twice Daily None for Children Approved adult dosing 2 mg 24 mg Adverse Effects: Diarrhea, dizziness, fatigue, hyperprolactinemia, nasal congestion, nausea, orthostatic hypotension, somnolence, tachycardia, xerostomia, cardiac arrhythmia, cerebrovascular accident, hyperglycemia, neuroleptic malignant syndrome, suicidal intent, syncope, transient ischemic attack Lurasidone* Latuda No pediatric data available Once daily with food None for Children Approved adult dosing 40 mg 160 mg Adverse Effects.

8 Akathisia, extrapyramidal signs, nausea, Parkinsonism, somnolence, agranulocytosis, cerebrovascular accident, neuroleptic malignant syndrome, orthostatic hypotension, seizure, suicidal thoughts, syncope, tardive dyskinesia, transient ischemic attacks Olanzapine* Zyprexa ZyPREXA Relprevv ZyPREXA Zydis Children 6 and Up mg mg Once to Twice Daily Schizophrenia (Ages 13-17) Acute treatment of manic or mixed episodes associated with bipolar I disorder (Ages 13-17) Adolescents mg 30 mg Adverse Effects.

9 Akathisia, appetite increase, asthenia, constipation, dizziness, edema, hypercholesterolemia, hyperprolactinemia, orthostatic hypotension, somnolence, tremor, weight gain, acute hemorrhagic pancreatitis, cardiac death, cerebrovascular disease, diabetic ketoacidosis, hyperglycemic hyperosmolar state, immune hypersensitivity reaction, neuroleptic malignant syndrome, pulmonary embolism, seizure, venous thromboembolism Quetiapine* SERO quel SERO quel XR Children 6 and Up mg 300 mg Once to Twice Daily Depending on the Preparation Schizophrenia (Ages 13-17) Mania with bipolar I disorder (Ages 10-17) Adjunctive maintenance treatment of bipolar disorder (Ages 10-17) Adolescents 25 mg 600 mg Adverse Effects.

10 Agitation, appetite increase, asthenia, constipation, dizziness, extrapyramidal signs, fatigue, headache, hypercholesterolemia, hypertension, insomnia, somnolence, vomiting, weight gain, xerostomia, agranulocytosis, cardiac arrhythmia, cardiac death, diabetic ketoacidosis, leukopenia, neuroleptic malignant syndrome, neutropenia, pancreatitis, priapism, seizure, suicidal thoughts, syncope, tardive dyskineisa PSYCHOTROPIC MEDICATION List Page 4 MEDICATION Name Age Group Recommended Initial Dosage/Day Recommended Maximum Dosages/Day Schedule FDA Approved Indications Second Generation (Atypical) Antipsychotics Risperidone* RisperDAL RisperDAL Consta RisperDAL M-Tab Children Under Six mg 2 mg Once to Twice Daily Schizophrenia (Ages 13-17) Acute treatment of manic or mixed episodes associated with bipolar I disorder (Ages 10-17)