The utility of stimulant medications in the treatment of attention deficit disorder (ADD) has been demonstrated repeatedly. Over 500,000 children receive these medications in the United States each year. The drugs, however, may be used inappropriately in cases where a presumptive diagnosis of "hyperactivity" is mistakenly made on the basis of nonspecific increases in activity levels or when an initial sedative response is taken as diagnostic confirmation of ADD. In this series of six cases, stimulant medications had been used inappropriately to manage a range of developmental problems. The importance of a careful diagnostic evaluation before instituting stimulants, careful monitoring, and a consideration of their risks are emphasized.
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