| Agent |
Starting dose* |
Usual effective dose |
Maximum daily dose |
Side effects |
|
| Amitriptyline |
25 mg po qhs |
100-150 mg qd |
300 mg |
Sedation, anticholinergic, orthostasis |
| Desipramine |
25 mg po qhs |
100-150 mg qd |
300 mg |
Less-sedating, less anticholinergic |
| Nortriptyline |
10 mg po qd |
75-100 mg qd |
150-200 mg |
Like desipramine |
| Doxepin |
25 mg po qhs |
100-150 mg qd |
300 mg |
Like amitriptyline; strong H1 antagonist |
| Carbamazepine |
100 mg po bid |
800 mg/day |
1600 mg |
Drowsiness, ataxia, GI upset, marrow suppression |
| Divalproex |
250 mg po bid |
1000 mg/day |
60 mg/kg |
Sedation, irritability, rash, GI upset |
| Phenytoin |
300 mg po qhs |
300 mg |
400-500 mg |
Nystagmus, ataxia, GI upset, marrow suppression |
| Gabapentin |
300 mg po qhs |
300 mg bid |
1800 mg |
Somnolence, dizziness, ataxia, fatigue, nystagmus |
| Mexilitene |
150 mg po bid |
450-600 mg/day |
1200 mg |
GI upset, dizziness, and rarely, cardiac arrhythmia |
|
