Skip to main content
SpringerLink
Log in

Medication for Hyperkinetic Children

  • Special Article
  • Published:
Drugs Aims and scope Submit manuscript

Summary

The hyperkinetic syndrome is a symptom complex of hyperactivity, short attention span, distractibility, impulsivity, learning difficulties, other behaviour problems and ‘equivocal’ neurological signs. However, none of these terms has ever been objectively defined and at present diagnosis is largely a matter of clinical judgement. In the management of the disorder, drugs do have a place but the decision to use medication is a complex procedure diagnostically and therapeutically calling for the highest in clinical skill and medical supervision. The most useful medication at present is the stimulant group of drugs, particularly dextroamphetamine and methylphenidate. Antipsychotic drugs are sometimes useful but carry the risk of depressing higher CNS functions such as attention and cognition. Other drugs which have been shown to be of value include tricyclic antidepressants (although their effect is less predictable and less striking than that of the stimulants) and pemoline.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ayllon, T.; Layman, D. and Kandel, M.J.: A behavioraleducational alternative to drug control of hyperactive children. Journal of Applied Behavioral Analysis 8: 137–146 (1975).

    Article  CAS  Google Scholar 

  • Brown, D.; Winsberg, B.; Bialer, I. and Press, N.: Imipramine therapy and seizures: Three children treated for hyperactive behavior disorders. American Journal of Psychiatry 130: 210–212 (1973).

    PubMed  CAS  Google Scholar 

  • Cantwell, D.: Psychiatric illness in the families of hyperactive children. Archives of General Psychiatry 27: 414–417 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Conners, C.: Pharmacotherapy; in Quay and Werry (Eds.) Psychopathology Disorders of Childhood, p.316–347 (Wiley, New York 1972).

    Google Scholar 

  • Conners, C.: The effect of pemoline and dextroamphetamine on evoked potentials under two conditions of attention; in Conners (Ed.) Clinical Use of Stimulant Drugs in Children, p.165–176 (Excerpta Medica, Amsterdam 1974).

    Google Scholar 

  • Conners, C.: A placebo-crossover study of caffeine treatment of hyperkinetic children. International Journal of Mental Health 4: 132–143 (1975).

    Google Scholar 

  • Conference on the Use of Stimulant Drugs in the Treatment of Behaviorally Disturbed Young Children: Psychopharmacology Bulletin 7: 23–26 (1971).

    Google Scholar 

  • Council on Child Health of the American Academy of Pediatrics: Medication for hyperkinetic children. Pediatrics 55: 560–561 (1975).

    Google Scholar 

  • De la Cruz, F.; Fox, B. and Roberts, R. (Eds.): Minimal brain dysfunction. Annals of the New York Academy of Sciences 205: 1–396 (1973).

  • Douglas, N.: Are drugs enough? — to treat or train the hyperactive child? International Journal of Mental Health 4: 199–212 (1975).

    Google Scholar 

  • Eisenberg, L.: Symposium: Behavior modification by drugs: III. The clinical use of stimulant drugs in children. Pediatrics 49: 709–715 (1972).

    PubMed  CAS  Google Scholar 

  • Gittelman-Klein, R. and Klein, D.: Methylphenidate effects in learning disabilities: I. Psychometric changes. Archives of General Pyschiatry (In press, 1975).

  • Gittelman-Klein, R.; Klein, D.; Katz, S.; Saraf, K. and Pollack, E.: Comparative effects of methylphenidate and thioridazine in hyperkinetic children: I. Clinical results (Submitted for publication, 1975).

  • Goodwin, D.; Schulsinger, F.; Hermansen, L.; Guze, S. and Winokur, G.: Alcoholism and the hyperactive child syndrome. Journal of Nervous and Mental Diseases 60: 349–353 (1975).

    Google Scholar 

  • Greenberg, L.; Yellin, A.; Spring, C. and Metcalf, M.: Clinical effects of imipramine and methylphenidate in hyperactive children. International Journal of Mental Health 4: 144–156(1975).

    Google Scholar 

  • Greenhill, L.; Rieder, R.; Wender, P.; Buchbaum, M. and Kahn, T.: Lithium carbonate in the treatment of hyperactive children. Archives of General Psychiatry 38: 636–640 (1973).

    Article  Google Scholar 

  • Greenblatt, D. and Shader, R.: in Benzodiazepines in Clinical Practice (Raven Press, New York 1974).

    Google Scholar 

  • Hayes, T.; Panitch, M. and Barker, E.: Imipramine dosage in children: A comment on ‘imipramine and electrocardiographic abnormalities in hyperactive children’. American Journal of Psychiatry 132: 546–547 (1975).

    PubMed  CAS  Google Scholar 

  • Illich, I.: in Medical Nemesis (Calder and Boyars, London 1975).

    Google Scholar 

  • Jacob, R.; O’Leary, K. and Price, G.: Behavioral treatment of hyperactive children: An alternative to medication (Submitted for publication, 1974).

  • Klein, D. and Gittleman-Klein, R.: Problems in the diagnosis of minimal dysfunction and the hyperkinetic syndrome. International Journal of Mental Health 4: 45–60 (1975a).

    Google Scholar 

  • Klein, D. and Gittelman-Klein, R.: Proposed revisions in the DSM 3 and ICD 9 (Personal communication, 1975b).

  • Krager, A. and Safer, D.: Type and prevalence of medication used in the treatment of hyperactive children. New England Journal of Medicine 291: 1118–1120 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Laufer, M. and Denhoff, E.: Hyperkinetic behavior syndrome in children. Journal of Pediatrics 50: 463–474 (1957).

    Article  PubMed  CAS  Google Scholar 

  • Lipman, R.: NIMH — PRB support of research in minimal brain dysfunction in children; in Conners (Ed.) Clinical Use of Stimulant Drugs in Children, p.202–213 (Excerpta Medica, Amsterdam 1974).

    Google Scholar 

  • Looker, A. and Conners, C.K.: Diphenylhydantoin in children with severe temper tantrums. Archives of General Psychiatry 23: 80–89 (1970).

    Article  PubMed  CAS  Google Scholar 

  • Martin, G. and Zaug, P.: Electrocardiographic monitoring of enuretic children receiving therapeutic doses of imipramine. American Journal of Psychiatry 132: 540–542 (1975).

    PubMed  CAS  Google Scholar 

  • Millichap, G. and Johnson, F.: Methylphenidate in hyperkinetic behavior: Relation of response to degree of activity and brain damage; in Conners (Ed.) Clinical Use of Stimulant Drugs in Children, p. 130–139 (Excerpta Medica, Amsterdam 1974).

    Google Scholar 

  • Montagu, J. and Swarbrick, L.: Effective amphetamines in hyperkinetic children: Stimulant or sedative? A pilot study. Developmental Medicine and Child Neurology 17: 293–298 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Morrison, J. and Stewart, M.: A family study of the hyperactive child syndrome. Biological Psychiatry 3: 189–195 (1971).

    PubMed  CAS  Google Scholar 

  • Ounsted, C.: ‘High activity in hyperactivity’. Developmental Medicine and Child Neurology 16: 685 (1974).

    PubMed  CAS  Google Scholar 

  • Page, J.; Bernstein, J.; Janicki, R. and Michellei, F.: A multi-clinic trial of pemoline in childhood hyperkynesis; in Conners (Ed.) Clinical Use of Stimulant Drugs in Children (Excerpta Medica, Amsterdam 1974).

    Google Scholar 

  • Patterson, G.; Jones, R.; Whittier, J. and Wright, M.: A behavior modification technique for the hyperactive child. Behavior Research and Therapy 2: 217–226 (1965).

    Article  Google Scholar 

  • Petti, T. and Campbell, M.: Imipramine and seizures. American Journal of Psychiatry 132: 538–540 (1975).

    PubMed  CAS  Google Scholar 

  • Rapoport, J. and Quinn, P.: Minor physical anomalies (stigmata) and early developmental deviation: A major biologic subgroup of ‘hyperactive children’. International Journal of Mental Health 4: 29–44 (1975).

    Google Scholar 

  • Rapoport, J.; Quinn, P.; Bradbard, G.; Riddle, K. and Brooks, E.: Imipramine and methylphenidate treatment of hyperactive boys. A double-blind comparison. Archives of General Psychiatry 30: 789–793 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Safer, D. and Allen, R.: Side-effects from long-term use of stimulants in children. International Journal of Mental Health 4: 105–118(1975).

    Google Scholar 

  • Saraf, K.; Klein, D.; Gittelman-Klein, R. and Gross, S.: Imipramine and side-effects in children. Psycho-pharmacologia 37: 265–274 (1974).

    Article  CAS  Google Scholar 

  • Satterfield, J. and Cantwell, D.: Psychopharmacology in the prevention of antisocial and delinquent behavior. International Journal of Mental Health 4: 227–237 (1975).

    Google Scholar 

  • Silbergeld, E. and Goldberg, A.: Pharmacological and neurological investigation of lead-induced hyper-activity. Neuropharmacology 14: 431–444 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Sleator, E.; von Neumann, A. and Sprague, R.: Hyperactive children: A continuous long-term placebocontrolled follow-up. Journal of the American Medical Association 229: 316–317 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Sprague, R.; Barnes, K. and Werry, J.: Methylphenidate and thioridazine: Learning, reaction time, activity and classroom behavior in disturbed children. American Journal of Orthopsychiatry 40: 615–628 (1970).

    Article  PubMed  CAS  Google Scholar 

  • Sprague, R. and Sleator, E.: Effects of psychopharma-cological agents on learning disorders. Pediatric Clinics of North America 20: 719–735 (1973).

    PubMed  CAS  Google Scholar 

  • Sprague, R. and Sleator, E.: What is the proper dose of stimulant drugs in children. International Journal of Mental Health 4: 75–104 (1975).

    Google Scholar 

  • Sprague, R. and Werry, J.: Psychotropic drugs in handicapped children; in Mann and Sabatino (Eds.) Second Review of Special Education, p. 1–50 (JSE Press, Philadelphia 1974).

    Google Scholar 

  • Sroufe, L. and Stewart, M.: Treating problem children with stimulant drugs. New England Journal of Medicine 289: 407–412 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Waizer, J.; Hoffman, S.; Polizos, P. and Engelhardt, D.: Outpatient treatment of hyperactive school children with imipramine. American Journal of Psychiatry 131: 587–591 (1974).

    PubMed  CAS  Google Scholar 

  • Weiss, B. and Laties, V.: Enhancement of human performance by caffeine and the amphetamines. Pharmacological Reviews 14: 1–36 (1962).

    PubMed  CAS  Google Scholar 

  • Weiss, G.: The natural history of hyperactivity in childhood and treatment with stimulant medication at different ages: A summary of research findings. International Journal of Mental Health 4: 213–226 (1975).

    Google Scholar 

  • Weiss, G.; Minde, K.; Douglas, B.; Werry, J. and Sykes, D.: Comparison of the effect of chlorpromazine, dextroamphetamine and methylphenidate on the behaviour and intellectual functioning of hyperactive children. Canadian Medical Association Journal 104: 20–25 (1971).

    PubMed  CAS  Google Scholar 

  • Wender, P.: in Minimal Brain Dysfunction in Children (Wiley, New York 1971).

    Google Scholar 

  • Wender, P.: Speculations concerning a possible biochemical basis of minimal brain dysfunction. International Journal of Mental Health 4: 11–28 (1975).

    Google Scholar 

  • Werry, J.S.: Developmental hyperactivity. Pediatric Clinics of North America 50: 581–599 (1968).

    Google Scholar 

  • Werry, J.: Minimal brain dysfunction (neurological impairment) in children. New Zealand Medical Journal 80: 94–100 (1974).

    PubMed  CAS  Google Scholar 

  • Werry, J. and Aman, M.: Methylphenidate and haloperidol in children. Effects on attention, memory and activity. Archives of General Psychiatry 32: 790–795 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Werry, J.; Aman, M. and Lampen, E.: Haloperidol and methylphenidate in hyperactive children. Acta Paedopsychiatrica (In press, 1975a).

  • Werry, J.; Dowrick, P.; Lampen, E. and Vamos, M.: Imipramine in enuresis — psychological and physiological effects. Journal of Child Psychology and Psychiatry 16: 289–300 (1975b).

    Article  PubMed  CAS  Google Scholar 

  • Werry, J.; Minde, K.; Guzman, A.; Weiss, G.; Dogan, K. and Hoy, E.: Studies on the hyperactive child. VII: Neurological status compared with neurotic and normal children. American Journal of Orthopsychiatry 42: 441–451 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Werry, J. and Sprague, R.: Hyperactivity; in Costello (Ed.) Symptoms of Psychopathology, p.397–417 (Wiley, New York 1970).

    Google Scholar 

  • Werry, J. and Sprague, R.: Methylphenidate in children — effect of dosage. Australia and New Zealand Journal of Psychiatry 8: 9–19 (1974).

    Article  CAS  Google Scholar 

  • Werry, J.; Sprague, R. and Cohen, M.: Conners’ Teacher Rating Scale for use in drug studies with children. Journal of Abnormal Child Psychology (In press, 1975c).

  • Werry, J.; Weiss, G.; Douglas, V. and Martin, J.: Studies on the hyperactive child. III. Effect of chlorpromazine on behavior and learning. Journal of the American Academy of Child Psychiatry 5: 292–312 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Whitehead, P. and Clark, L.: Effect of lithium carbonate, placebo and thioridazine on hyperactive children. American Journal of Psychiatry 127: 124–125 (1970).

    Google Scholar 

  • Winsberg, B.; Bialer, I.; Kupietz, S. and Tobias, J.: Effects of imipramine and dextroamphetamine on behavior of neuropsychiatrically impaired children. American Journal of Psychiatry 128: 1425–1431 (1972).

    PubMed  CAS  Google Scholar 

  • Winsberg, B.; Goldstein, S.; Yepes, L. and Perel, J.: Imipramine and electro cardiographic abnormalities in hyperactive children. American Journal of Psychiatry 132: 542–545 (1975).

    PubMed  CAS  Google Scholar 

  • Winsberg, B.; Press, M.; Bialer, I. and Kupietz, S.: Dextroamphetamine and methylphenidate in the treatment of hyperactive/aggressive children. Pediatrics 53: 236–241 (1974).

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, School of Medicine, University of Auckland, Private Bag, Auckland, New Zealand

    J. S. Werry

Authors
  1. J. S. Werry
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Werry, J.S. Medication for Hyperkinetic Children. Drugs 11, 81–89 (1976). https://doi.org/10.2165/00003495-197611020-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-197611020-00001

Keywords

Search

Navigation