Dosing Guidelines for Desoxyn (Methamphetamine)
For treatment of ADHD in children 6 years or older, Desoxyn should be initiated at 5 mg once or twice daily, with dosage increases of 5 mg at weekly intervals until optimal clinical response is achieved, with a usual effective dose of 20-25 mg daily given in two divided doses. 1
Initial Assessment and Baseline Monitoring
Before starting Desoxyn treatment:
- Assess for cardiac disease through careful history, family history of sudden death or ventricular arrhythmia, and physical examination
- Evaluate for motor/verbal tics or Tourette's syndrome
- Obtain baseline vital signs including blood pressure, pulse, height, and weight
- Complete a physical examination to identify any contraindications
Dosing Protocol
Children (6 years and older with ADHD):
- Starting dose: 5 mg once or twice daily 1
- Titration: Increase by 5 mg at weekly intervals 1
- Target dose: 20-25 mg daily in two divided doses 1
- Maximum daily dose: 40 mg (per amphetamine guidelines) 2
- Children weighing less than 25 kg should not receive single doses greater than 10 mg 2
Administration Timing:
- Morning dose: After breakfast
- Second dose: Around noon after lunch
- Avoid late evening administration due to insomnia 1
Titration and Monitoring
- Use a consistent titration schedule, increasing dose weekly if symptom control is not achieved 2
- During initial titration, maintain weekly contact (in person or by telephone) 2
- After stabilization, follow-up at least monthly until symptoms are well-controlled 2
- Monitor vital signs regularly:
- Children: Annual blood pressure, pulse, height, and weight checks
- Adults: Quarterly blood pressure and pulse checks 2
Side Effect Management
Common side effects requiring monitoring:
- Appetite suppression (weigh patient at each visit)
- Insomnia
- Headaches
- Social withdrawal
- Tics
- Weight loss 2
Important Considerations
- If maximum recommended dose does not provide adequate symptom control, consider changing medication rather than exceeding recommended doses 2
- The PDR maximum daily dose for amphetamines is 40 mg, though clinical consensus suggests doses may occasionally exceed this in rare cases 2
- Avoid late evening dosing to prevent insomnia 1
- Desoxyn should be administered at the lowest effective dosage 1
Treatment Response Assessment
- Regularly evaluate target ADHD symptoms through parent and teacher reports
- For adolescents, include self-ratings in assessment
- Consider using standardized rating scales to track progress 2
Remember that while Desoxyn is effective for ADHD symptoms, careful monitoring is essential due to its potential for side effects and its controlled substance status. Always prioritize using the lowest effective dose that improves symptoms while minimizing adverse effects.