Drugs in Management of Hyperkinetic and Perceptually Handicapped Children

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.