Anticonvulsants-Dosage (Part-I)

In this article, we will discuss Anticonvulsants-Dosage (Part-I). So, let’s get started.

Anticonvulsants

ACTH 30-40 iu daily IM or SC for 4 weeks followed by gradual tapering doses over next 2 weeks.

Indication: Infantile spasms, West syndrome.

C/I: Cushing disease, tuberculosis, and fungal infections.

(Inj corticotrophin, synacthen, acthar gel 40 units and 80 units per ml in 2 ml and 5 ml vials; Acton prolongatum 60 units per ml, 5 ml vials).

Carbamazepine 10–30 mg/kg/day q8 hr oral (maximum 1000 mg/day). Retard preparation can be given 12 hourly. Therapy should be initiated at 30 to 50% of initial target dose and increased every 5 to 7 days.

Adult dose: 100-200 mg once or twice daily initially, then increase to 400 mg q 8-12 hr. Maximum dose 1.5-2 gm daily.

Indication: Partial tonic-clonic seizures, mesial temporal lobe epilepsy syndrome, myoclonus due to subacute sclerosing panencephalitis (SSPE), trigeminal neuralgia, prophylaxis for depressive psychosis, and post-herpetic neuralgia.

C/I: Patients on monoamine oxidase inhibitors, AV conduction defects, bone marrow depression and porphyria. Avoid in patients with infantile and juvenile myoclonic epilepsy and absence epilepsy.

(Mazetol, carbatol, tegrital, zeptol tabs 100 mg, 200 mg, 400 mg; syrup mazetol, tegrital 100 mg per 5 ml; mazetol SR, salicarb SR, tegrital CR, zeptol CR, zen retard tabs 200 mg, 400 mg)

Clobazam 0.1 mg/kg/day initial dose. Usual maintenance dose 0.3-1 mg/kg/day at bedtime or q 12 hr. 1 mg/kg/day q 12 h for 2-3 days for prophylaxis against febrile seizures.

Adult dose: 10-30 mg daily in 2 divided doses. Maximum daily dose 60 mg.

C/I: Myasthenia gravis, hypersensitivity to benzodiazepines.

Indication: Effective as an add-on drug in complex partial, generalized tonic or tonic-clonic seizures, absence attacks, myoclonic seizures, atonic seizures and Lennox-Gestaut syndrome, prophylaxis for febrile seizures, reflex epilepsy, continuous spike-waves during slow sleep (CSWS).

Side Effects: Constipation, behaviour changes, aggression, sleep disturbances and weight gain.

(Frisium, clozam, cloba, lobazam tabs 5 mg, 10 mg, 20 mg).

Clonazepam 0.01-0.03 mg/kg/day q 8-12 hr oral. Increase every 3 days by 0.25-0,5 mg till a maximum dose of 0.2 mg/kg/day is reached.

Adult dose: Initially 0.5 mg 9 12 hr, increase by 0.5 mg/day every 3-7 days till maintenance dose of 4-8 mg/day.

C/I: Significant liver disease, acute narrow angle glaucoma.

Indication: Add-on therapy for atonic, akinetic epilepsy, resistant absence attacks, myoclonus, infantile spasms, and Lennox-Gestaut syndrome

(Clonotril, rivotril, lonazep, lonacen, zozep, sezolep, ozepam tabs 0.5 mg, 2 mg; melzap, zapiz tabs 0.25 mg, 0,5 mg, 1 mg, 2 mg)

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