PEDIATRICS Vol. 49 No. 5 May 1972, pp. 709-715
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Eisenberg, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Eisenberg, L.

SYMPOSIUM: BEHAVIOR MODIFICATION BY DRUGS

III. THE CLINICAL USE OF STIMULANT DRUGS IN CHILDREN

Leon Eisenberg M.D.1

1 Department of Psychiatry, Harvard Medical School, and the Massachusetts General Hospital, Boston, Massachusetts

Having reviewed what is known, what is only surmised, and what is not known about the psychopharmacology of stimulant drug use in children, the clinician must decide for which patient to use what drug for how long. Medical practice does not permit the physician the luxury of deferring decisions until knowledge is certain. His task is to weigh putative benefits against putative risks in a strategy designed to maximize the probability of improvement for a particular patient.

The risks that concern the pediatrician are not only those visible in the short run during drug administration but include effects on development, effects which may not become apparent for some time after treatment has been discontinued. In the case of stimulant drugs, public controversy has centered on behavioral rather than pharmacological toxicity, both short and long run. In the short run, are the drugs being used indiscriminately to stifle independence and creativity among exceptional children? Over the long run, does childhood drug use predispose to adolescent drug addiction? Before attempting to answer these questions, let us first consider the medical indications for the use of stimulants and the mode of their administration.

The clinical syndromes which respond to stimulants are characterized by motor restlessness, short attention span, poor impulse control, learning difficulties, and emotional lability. Current American Psychiatric Association diagnostic nomenclature1 includes the term: "hyperkinetic reaction of childhood" to describe this set of symptoms; the World Health Organization2 is proposing: "hyperkinetic syndrome." Both terms have the virtue of stressing the symptom constellation and of by-passing the uncertainties surrounding cause.




This article has been cited by other articles:


Home page
 PediatricsHome page
D. Efron, F. Jarman, and M. Barker
Methylphenidate Versus Dexamphetamine in Children With Attention Deficit Hyperactivity Disorder: A Double-blind, Crossover Trial
Pediatrics, December 1, 1997; 100(6): e6 - e6.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
K. D. O'Leary, W. E. Pelham, A. Rosenbaum, and G. H. Price
Behavioral Treatment of Hyperkinetic Children: An Experimental Evaluation of Its Usefulness
Clinical Pediatrics, June 1, 1976; 15(6): 510 - 515.
[PDF]