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J. Gordon Millichap, MD

JAMA. 1968;206(7):1527-1530.

Abstract
Drugs are useful in the symptomatic treatment of hyperkinetic and perceptually handicapped children, but their administration should be preceded by a careful clinical evaluation. On the basis of present evidence, short-term trials of drugs are justified as an adjunct to remedial methods of education. Central nervous system stimulants are the agents of choice. Chlordiazepoxide and chlorpromazine are recommended as alternative agents in patients who fail to respond to methylphenidate or dextroamphetamine. Diphenylhydantoin sodium or primidone, alone or in combination with a stimulant or antianxiety or antipsychotic agent, is indicated when signs and symptoms of minimal brain dysfunction include seizures or electroencephalographic evidence of epilepsy. Phenobarbital usually exacerbates hyperactivity and is contraindicated. The use of central nervous system stimulants and mood-modifying agents for prolonged periods should await further evaluation by long-term controlled studies.

Author Affiliations
From the Division of Neurology, Children's Memorial Hospital, and the departments of pediatrics and neurology, Northwestern University Medical School, Chicago.

Footnotes
This communication was invited by the Drug Utilization Section of the Council on Drugs.

Reprint requests to Secretary, Council on Drugs, American Medical Association, 535 N Dearborn St, Chicago 60610.

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