Dosing of NMDA antagonists

The dose of dextromethorphan in children over the age 12 years is 30 mg every six to eight hours up to a maximum dose of 120 mg/24 hours. The adult recommended dose of memantine is 5 mg/24 hours, up to a maximum dose of 20 mg/24 hours. Future studies are needed to demonstrate the efficacy and safety of botulinum toxins for pediatric tension headache and other complementary therapies of magnesium, riboflavin, feverfew, and butterbur.112[V]

Table 44.6 Anticonvulsants: recommended oral dosing.

Anticonvulsant Recommended dose

Carbamazepine 5-10mg/kg/24 hours divided into two doses; incremental increase of 10mg/kg/24 hours per week; maximum dose for children over the age of 12 years is 1.6-2.4 g/24 hours Oxcarbazepine For children over the age of 12 years, dose is 300-600 mg/24 hours; maximum dose 900-2400 mg/24 hours

Phenytoin 2-3 mg/kg divided into two to three doses per day, incremental increase of 0.5 mg/kg every 3-4 weeks;

maximum dose 5mg/kg per day (1000 mg per day) Valproic acid 5-15 mg/kg administered in a single night-time dose or three divided doses per day; incremental increase of

5-10mg/kg every 5-7 days; maximum dose 60mg/kg/day Gabapentin 5-10 mg/kg administered either once, twice, or three times a day; maximum dose 2400-3600 mg/24 hours

Lamotrigine 0.15-0.6 mg/kg/24 hours administered in a single night-time dose or twice-a-day divided dose; slow incremental increase every 2 weeks Levetiracetam 10 mg/kg/24 hours, prescribed in twice-a-day divided doses

Topiramate 1-3 mg/kg/24 hours; maximum dose 600 mg/24 hours

Zonisamide 2-4 mg/kg/24 hours; maximum dose 400 mg/24 hours

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