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Benzedrine in behavior disorders of children
Psychologic Aspects of Pediatrics B E N Z E D R I N E IN B E H A V I O R D I S O R D E R S O F C H I L D R E N HARRY BAKWIN, M.D. N E w YORK, N . Y.
results have been reported in the treatment with benzedrine F AVORABL.E of a large variety of psychic disturbances in children2. ~ Bradley and Bowen ~ obtained relief not only in behavior disorders of psychogenic origin but in problems of such widely different etiologies as convulsive disorders, schizoid personality, structural neurol0gieat defects, intellectual deficiency, specific reading difficulty, and posteneephalitis. Seventy-two out of 100 children showed improvement. Bender 2 emphasizes the usefulness of benzedrine where the behavior disturbance is characterized by fear, depression, sexual tension, and hyperactivity. She observed no appreciable benefit upon the behavior of children with schizophrenia and an unfavorable effect in children with psychopathic personality. In contrast to its stimulating effect in adults, benzedrine in children generally leads to a subdued type of behavior. Children who habitually rush about and shout become quieter, less noisy, and better controlled. They are more alert mentatly and more considerate of the feelings and opinions of those around them. In a certain number of children benzedrine results in a greater show of e n e r g y . The children are more alert, show more initiative, more aggression in competitive activities, and a greater interest in their environment. In general, school accomplishment is more satisfactory. There is increased attention to academic work. Distractibility, fluctuations in mood, and daydreaming are lessened. According' to Bradley and Bowen 8 performance in arithmetic was improved most, in spelling, least. This effect is produced by altering the emotional attitude of the child toward his intellectual tasks rather than by stimulating the higher nerve centers. Administration.--Benzedrine is given once a day in the morning on rising'. The initial dose varies from 2.5 to 10.0 rag. a day, depending on tile age of the patient. It is increased every other day nntiI a therapeutic or toxic effect results. F o r children requiring more than 30 rag. a day or where the morning response is not sustained, the daily dose is divided in two and is given in the morning" and just before the noon meal. There is no close relationship between age and the amount of medication required. The effects of treatment may be observed within an hour after administration. They are maximal in two to three hours and generally persist for five to eight hours. According to B r a d l e y and Bowen 1 there is no toleration to the From the Department of Pediatrics, New York University College of Medicine.
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216
THE
JOURNAL
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PEDIATRICS
drug, the effect persisting, in the large majority of instances, as long as the drug is administered. There are no serious drawbacks to the use of benzedrine in children. Occasionally a child's behavior becomes worse. In a number of children there is insomnia, but 'this wears off quickly. Loss of appetite is more frequent and more persistent but is not enough ordinarily to lead to significant weight loss. Occasionally dizziness, nausea, and vomiting occur within a few hours of administration. I f these symptoms persist after a day or two, the dosage must be reduced. In some instances fine tremors of the extremities are observed. They usually persist but are not marked tinued treatment.
and are not a contraindieation
to con-
Benzedrine is a useful aid in the treatment of disturbed children. It gives the neurotic child a feeling of well-being and temporarily allows him to feel secure. While in this frame of mind he can better face his difficulties and thereby obtain relief from inner tension and anxiety. I t is i m p o r t a n t to keep in mind that the drug is no substitute for more intensive therapy. It is useful only a s an adjunct to adequate psychotherapy. It is self-evident that the drug does not remove the sources of conflict which led to the difficulty. REFERENCES 1. Bradley, C., and Bowen, 1~[.: Amphetamine (Benzedrine) Therapy of Children's Behavior Disorders, Am. J. 0rthopsychiat. 11: 92, 1941. 2. Bender, L., and Cottington~ F.: The Use of Amphetamine Sulfate (Benzedrine) in Child ]Psychiatry, Am. J. Psychiat. 99: 116, 1942. 3. Bradley, A., and Bowen, :~[.: School ]Performance of Children Receiving Amphetamine (Benzedrine) Sulfate, Am. J. Orthopsychiat. :tO: 4, 1940.
results have been reported in the treatment with benzedrine F AVORABL.E of a large variety of psychic disturbances in children2. ~ Bradley and Bowen ~ obtained relief not only in behavior disorders of psychogenic origin but in problems of such widely different etiologies as convulsive disorders, schizoid personality, structural neurol0gieat defects, intellectual deficiency, specific reading difficulty, and posteneephalitis. Seventy-two out of 100 children showed improvement. Bender 2 emphasizes the usefulness of benzedrine where the behavior disturbance is characterized by fear, depression, sexual tension, and hyperactivity. She observed no appreciable benefit upon the behavior of children with schizophrenia and an unfavorable effect in children with psychopathic personality. In contrast to its stimulating effect in adults, benzedrine in children generally leads to a subdued type of behavior. Children who habitually rush about and shout become quieter, less noisy, and better controlled. They are more alert mentatly and more considerate of the feelings and opinions of those around them. In a certain number of children benzedrine results in a greater show of e n e r g y . The children are more alert, show more initiative, more aggression in competitive activities, and a greater interest in their environment. In general, school accomplishment is more satisfactory. There is increased attention to academic work. Distractibility, fluctuations in mood, and daydreaming are lessened. According' to Bradley and Bowen 8 performance in arithmetic was improved most, in spelling, least. This effect is produced by altering the emotional attitude of the child toward his intellectual tasks rather than by stimulating the higher nerve centers. Administration.--Benzedrine is given once a day in the morning on rising'. The initial dose varies from 2.5 to 10.0 rag. a day, depending on tile age of the patient. It is increased every other day nntiI a therapeutic or toxic effect results. F o r children requiring more than 30 rag. a day or where the morning response is not sustained, the daily dose is divided in two and is given in the morning" and just before the noon meal. There is no close relationship between age and the amount of medication required. The effects of treatment may be observed within an hour after administration. They are maximal in two to three hours and generally persist for five to eight hours. According to B r a d l e y and Bowen 1 there is no toleration to the From the Department of Pediatrics, New York University College of Medicine.
215
216
THE
JOURNAL
OF
PEDIATRICS
drug, the effect persisting, in the large majority of instances, as long as the drug is administered. There are no serious drawbacks to the use of benzedrine in children. Occasionally a child's behavior becomes worse. In a number of children there is insomnia, but 'this wears off quickly. Loss of appetite is more frequent and more persistent but is not enough ordinarily to lead to significant weight loss. Occasionally dizziness, nausea, and vomiting occur within a few hours of administration. I f these symptoms persist after a day or two, the dosage must be reduced. In some instances fine tremors of the extremities are observed. They usually persist but are not marked tinued treatment.
and are not a contraindieation
to con-
Benzedrine is a useful aid in the treatment of disturbed children. It gives the neurotic child a feeling of well-being and temporarily allows him to feel secure. While in this frame of mind he can better face his difficulties and thereby obtain relief from inner tension and anxiety. I t is i m p o r t a n t to keep in mind that the drug is no substitute for more intensive therapy. It is useful only a s an adjunct to adequate psychotherapy. It is self-evident that the drug does not remove the sources of conflict which led to the difficulty. REFERENCES 1. Bradley, C., and Bowen, 1~[.: Amphetamine (Benzedrine) Therapy of Children's Behavior Disorders, Am. J. 0rthopsychiat. 11: 92, 1941. 2. Bender, L., and Cottington~ F.: The Use of Amphetamine Sulfate (Benzedrine) in Child ]Psychiatry, Am. J. Psychiat. 99: 116, 1942. 3. Bradley, A., and Bowen, :~[.: School ]Performance of Children Receiving Amphetamine (Benzedrine) Sulfate, Am. J. Orthopsychiat. :tO: 4, 1940.