Judges’ reference table for the september 2013 psychotropic medication utilization parameters for foster children

Judges’ Reference Table for the September 2013 Psychotropic Medication
Utilization Parameters for Foster Children
Stimulants (for treatment of ADHD)
FDA Approved Maximum Dosage for Children and Adolescents Approved for children 3 years and older up to 40 mg/day Approved for children 6 years and older up to 30 mg/day Approved for children 6 years and older up to 20 mg/day Approved for children 6 years and older up to 30 mg/day Approved for children 6 years and older up to 40 mg/day Dexedrine Spansule Approved for children 6 years and older up to 40 mg/day Approved for ADHD for children 6 years and older up to 70 mg/day Approved for children 6 years and older: Children 54 mg/day; Approved for children 6 years and older up to 30 mg/day Approved for children 6 years and older up to 60 mg/day Approved for children 6 years and older up to 60 mg/day Approved for children 6 years and older up to 60 mg/day Approved for children 6 years and older up to 60 mg/day Approved for children 6 years and older up to 60 mg/day Approved for children 6 years and older up to 60 mg/day Approved for children 6 years and old up to 60 mg/day Other ADHD Treatments
FDA Approved Maximum Dosage for Children and Adolescents Approved for children 6 years and older up to 1.4 mg/kg/day or ≤ 100 Not approved for children and adolescents Not approved for children and adolescents Not approved for children and adolescents Immediate release not approved for children and adolescents Extended release approved for children 6 and older up to 0.4 mg/day Not approved for children and adolescents Approved for ADHD in children 6 years and older up to 4 mg/day Approved for Enuresis in children 6 years and older up to 2.5 mg/kg/day Not approved for children and adolescents Not approved for children and adolescents Not approved for children and adolescents Judges’ Reference Table for the September 2013 Psychotropic Medication
Utilization Parameters for Foster Children
Antidepressants, SSRIs
FDA Approved Maximum Dosage for Children and Adolescents Not approved for children and adolescents Not approved for children. Approved for Major Depressive Disorder in adolescents (12-17 years) up to Approved for children 8 years and older for MDD up to 20 mg/day and for OCD up to 60 mg/day.
Approved for treatment of OCD in ages 8-11 up to 200 mg/day and ages 12-17 up to 300 mg/day Approved for treatment of OCD in ages 8-11 up to 200 mg/day and ages 12-17 up to 300 mg/day Not approved for children and adolescents Not approved for children and adolescents Approved for treatment of OCD in children 6 years and older up to 200 mg/day * Note: There is currently insufficient evidence for use and dosage. Off label use may occur when other medications have failed.
Antidepressants, SNRIs
FDA Approved Maximum Dosage for Children and Adolescents Not approved for children and adolescents Not approved for children and adolescents Not approved for children and adolescents * Note: There is currently insufficient evidence for use and dosage. Off label use may occur when other medications have failed.
Judges’ Reference Table for the September 2013 Psychotropic Medication
Utilization Parameters for Foster Children
Antipsychotics: Second Generation (Atypical)
FDA and/or Literature FDA and/or Literature FDA Approved Maximum Dosage for Children and Adolescents Approved for Bipolar Mania or Mixed Episodes in pediatric patients (10 to 17 years) and Schizophrenia in adolescents (13-17 years) up to 30mg/day and for irritability associated with autistic disorder (6-17 years) up to 15mg/day Not approved for children and adolescents Not approved for children and adolescents Not approved for children and adolescents Not approved for children and adolescents Approved for Bipolar Mania or Mixed Episodes and Schizophrenia in adolescents (13-17 years) up to 20 mg/day. Not approved in children Approved for Schizophrenia (12-17 years) up to 12 mg/day Approved for Bipolar Mania (10-17 years) and for Schizophrenia in adolescents (13-17 years) up to 600 mg/day. Not approved for children.
Approved for Bipolar Mania or Mixed Episodes in children and adolescents (10-17 years) and Schizophrenia in adolescents (13-17 years) 6 mg/day and irritability associated with Autistic Disorder (5-16 years) 3 mg/day Not approved for children and adolescents * Note: There is currently insufficient evidence for use and dosage. Off label use may occur when other medications have failed.
Antipsychotics: First Generation
FDA Approved Maximum Dosage for Children and Adolescents Approved for treatment of severe behavioral problems in children (6 months to 12 years). Outpatient Children: 0.25mg/pound every 4-6 hours. Inpatient Children: 500mg/day in older children. Adolescents 1000 mg/dayApproved for treatment of Psychotic Disorders, Tourette’s Disorder, and severe behavioral problems in children 3 years and older. Psychosis: 0.15mg/kg/day. Tourette’s and severe behavioral problems: 0.075mg/kg/day. Maximum dose: 6mg/day Approved for treatment of psychotic disorders in adolescents 12 years and older up to 64mg/day Approved for treatment of Tourette’s Disorder in adolescents 12 years and older up to 10mg/day Judges’ Reference Table for the September 2013 Psychotropic Medication
Utilization Parameters for Foster Children
Mood Stabilizers
FDA Approved Maximum Dosage for Children and Adolescents Approved for Seizure Disorders in all ages. Maximum dosages; Under 6 years: 35 mg/kg/day, 6-12 years: 800mg/day, 12-15 years: 1000 mg/day, >15 years: 1200 mg/dayApproved for Seizure Disorders in all ages. Maximum dosages; Under 6 years: 35 mg/kg/day, 6-12 years: 800mg/day, 12-15 years: 1000 mg/day, >15 years: 1200 mg/dayApproved for Seizure Disorders in all ages. Maximum dosages; Under 6 years: 35 mg/kg/day, 6-12 years: 800mg/day, 12-15 years: 1000 mg/day, >15 Approved for Seizure Disorders in 10 years and older Maximum dose based Serum level: 50-125 mcg/ml or Serum level: 50-125 mcg/ml or upon serum level. Serum level: 50-100 mcg/ml or 60 mg/kg/day Approved for adjunctive therapy for Seizure Disorders in 2 years and older up to 500 mg/day. Safety and effectiveness for treatment of Bipolar Disorder in patients below 18 years has not been established.
Approved for manic episodes and maintenance of Bipolar Disorder in 12 years and older up to a blood serum level of 0.6-1.2 mEq/L Approved for manic episodes and maintenance of Bipolar Disorder in 12 years and older up to a blood serum level of 0.6-1.2 mEq/L Approved for manic episodes and maintenance of Bipolar Disorder in 12 years and older up to a blood serum level of 0.6-1.2 mEq/L Approved for seizure disorders as monotherapy in age ≥ 4 years or adjunc- tive therapy in age ≥ 2 years: 60 mg/kg/day or 1800 mg/day Sedatives/Hypnotics
FDA Approved Maximum Dosage for Children and Adolescents Approved for treatment of insomnia (age ≥12 years): 50 mg at bedtime Approved for treatment of anxiety and tension: Approved as a sedative when used as a premedication and following general * Note: There is currently insufficient evidence for use and dosage. Off label use may occur when other medications have failed.

Source: https://www.dfps.state.tx.us/documents/Child_Protection/pdf/Judges_Reference_Table_for_Sept2013_Parameters.pdf