Medication	Dosage range	Common adverse effects	Monitoring/special considerations
Stimulants
Methylphenidate (Ritalin)	For children six years and older: 2.5 to 5.0 mg per dose given before breakfast and lunch to maximum dosage of 2 mg per kg per day or 60 mg per day	Anorexia, nervousness, sleep delay, restlessness, dysrhythmias, palpitations, tachycardia, anemia, leukopenia	Periodic CBC with differential and platelet count, blood pressure, height, weight, heart rate Tolerance or dependence can occur. Drug holidays should be considered.
	Additional dose of 2.5 mg may be required, not to be given after 4 p.m.
Dextroamphetamine (Dexedrine)	Amphetamine therapy is not recommended for children younger than three years. 3 to 5 years: 2.5 mg per day; increased by 2.5 mg at weekly intervals (not to exceed 0.5 mg per kg per day) > 6 years: 5 mg three times daily; increase by 5 mg at weekly intervals; maximum dosage of 40 mg per day	Anorexia, dependence, hyperactivity, sleep delay, restlessness, talkativeness, palpitations, tachycardia	CNS activity, height, weight, blood pressure Tolerance or dependence can occur. Do not discontinue abruptly.
Antidepressants
Bupropion (Wellbutrin)*	50 to 150 mg every day Adolescents and children older than six years: 1.4 to 6.0 mg per kg per day in divided doses	Agitation, anxiety, confusion, headache/migraine, insomnia, seizures, arrhythmias, nausea, vomiting
Fluoxetine (Prozac)	5 to 20 mg per day: dose should be titrated slowly; maximum dosage in adults is 80 mg per day; no dosage information in children < 5 years	Anxiety, dizziness, drowsiness, fatigue, headache, insomnia, nervousness, tremor, anorexia, diarrhea, dyspepsia	Drug interactions (metabolized by the CYP450 pathway)
Anticonvulsants
Phenytoin (Dilantin)	5 mg per kg per day in 2 to 3 divided doses to a maximum of 300 mg per day	Dizziness, psychiatric changes, slurred speech, gingival hyperplasia, constipation, nausea, vomiting	Serum concentrations, CBC with differential, liver enzymes Drug interactions
Carbamazepine (Tegretol)	< 6 years: 10 to 20 mg per kg per day in 2 to 3 divided doses; maximum dosage of 35 mg per kg per day 6 to 12 years: 100 mg twice daily; increase by 100 mg at weekly intervals; maximum dosage of 1,000 mg per day	Ataxia, drowsiness, constipation, diarrhea, nausea	CBC with platelet count, liver function tests
Valproic acid (Depakene)	10 to 15 mg per kg per day in 1 to 3 divided doses; increase by 5 to 10 mg per kg per day at weekly intervals	Drowsiness, sedation, constipation, diarrhea, heartburn, nausea, vomiting, rash	Liver function tests, bilirubin, CBC with platelet count
Other
Lithium	Children: 15 to 60 mg per kg per day in 3 to 4 divided doses Adolescents: 600 to 1,800 mg per day in 3 to 4 divided doses	Dizziness, drowsiness, fine hand tremor, headache, hypotension, anorexia, diarrhea, dry mouth, nausea, vomiting, polyurea	Drug interactions Serum lithium concentrations prior to next dose, monitor biweekly until stable then every 2 to 3 months; serum creatinine, CBC, urinalysis, serum electrolyte, fasting glucose, echocardiogram, TSH
Clonidine (Catapres)	0.05 mg per day; increase every 3 to 7 days by 0.05 mg per day to 3 to 5 μg per kg per day in 3 to 4 divided doses	Dizziness, drowsiness, sedation, constipation, dry mouth	Blood pressure, heart rate Do not discontinue abruptly or withdrawal symptoms may occur.
	Maximum dose: 0.3 to 0.4 mg per day