Six children with the diagnosis of Attention Deficit Disorder were treated as day hospital patients, using different stimulant medication. They were studied in a double-blind crossover experiment in which they received caffeine in low dose or in a high dose. Methylphenidate was added to both dosages, as well as administered alone. Results indicated that caffeine in low dosage when added to methylphenidate was superior to all other treatment conditions. Caffeine in low dosage could not be differentiated from 10 mg of methylphenidate. High dosage caffeine was not different from placebo or no-drug conditions. This study offers evidence to support a curvilinear pattern of dose-response for caffeine, in attenuating the behavioural manifestations of this syndrome.
References
1.
BarkleyR.A review of stimulant drug research with hyperactive children. J Child Psychol Psychiatry1977; 18:137-65.
2.
RapoportJL, QuinnPO, LamprechtF.Minor physical anomalies and plasma dopamine-beta-hydroxylase activity in hyperactive boys. Am J Psychiatry1974; 131:386.
3.
MillichapJG. Drugs in management of minimal brain dysfunction. Ann NY Acad Sci1973; 205:321-34.
4.
SroufeLA, StewartMA. Treating problem children with stimulant drugs. N Engl J Med1973; 289:407-12.
5.
SpragueRL, BarnesKR, WerryJS. Methylphenidate and thioridazine learning, reaction time, activity, and classroom behaviour in disturbed children. Am J Orthopsychiatry1970; 40:615-28.
6.
WerryJS, WeissG, DouglasV, et al. Studies on the hyperactive child: III. The effect of chlorpromazine on behaviour. J Am Acad Child Psychiatry1966; 5:292-312.
7.
WinsbergBG, BialerI, DupietzS, et al. Effects of imipramine and dextroamphetamine on behaviour of neuropsychiatrically impaired children. Am J Psychiatry1972; 128:1425-31.
8.
DrakowskiAJ. Amitriptyline in treatment of hyperkinetic children: a double-blind study. Psychosomatics1965; 6:355-60.
9.
ZrullJP, WestmanJC, ArthurB, et al. A comparison of chlordiazepoxide, d-amphetamine, and placebo in the treatment of hyperkinetic syndrome in children. Am J Psychiatry1963; 120:590-91.
10.
GreenbergLM, DeemMA, McMahonS.Effects of dextroamphetamine, chlorpromazine, and hydroxyzine on behaviour and performance in hyperactive children. Am J Psychiatry1972; 129:532-39.
11.
CarmanJS, TuckerLS. Benztropine in childhood hyperkinesis (ltr to ed) Lancet1973; 2:1337-38.
12.
GreenhillLL, RiederRO, WenderPH, et al. Lithium carbonate in the treatment of hyperactive children. Arch Gen Psychiatry1973; 28:636-40.
13.
LehmannG.Physiologically important constituents of coffee. Ernahrungs-Umschau1971; 18:43-47.
14.
SchnackenbergRC. Caffeine as a substitute for schedule II stimulants in hyperkinetic children. Am J Psychiatry1973; 130:796.
15.
GrossMD. Caffeine in the treatment of children with minimal brain dysfunction of hyperkinetic syndrome. Psychosomatics1975; 16:26.
16.
ConnersCK. A placebo-crossover study of caffeine treatment of hyperkinetic children. Int J Ment Health1975; 4:132.
17.
HeustisRD, ArnoldLE, SmeltzerDJ. Caffeine versus methylphenidate and d-amphetamine in minimal brain dysfunction: a double-blind comparison. Am J Psychiatry1975; 132:868.
18.
ArnoldLE, ChristopherJ, HeustisR, SmeltzerDJ. Methylphenidate vs. dextroamphetamine vs. caffeine in minimal brain dysfunction. Arch Gen Psychiatry1978; 35:467-73.
19.
GarfinkelBD, WebsterCD, SlomanL.Methylphenidate and caffeine in the treatment of children with minimal brain dysfunction. Am J Psychiatry1975; 132:723.
20.
GarfinkelBD, WebsterCD, SlomanL.Individual responses to methylphenidate and caffeine in children with minimal brain dysfunction. Can Med Assoc J1975; 113:729.
21.
ReichardCC, ElderST. The effects of caffeine on reaction time in hyperkinetic and normal children. Am J Psychiatry1977; 134:144.
22.
HarveyDH, MarshRW. The effects of de-caffeinated coffee versus whole coffee on hyperactive children. Develop Med Child Neurol1978; 20:81-86.
23.
ConnersCK. A teacher rating scale for use in drug studies with children. Am J Psychiatry1969; 126:884.
24.
KupietzS, BottiE.Behaviour measurement in pediatric psychopharmacology. (ltr to ed). Am J Psychiatry1974; 131:106.
25.
GilbertRM, MarshmanJA, SchwiederM, BergR.Caffeine content of beverages as consumed. Can Med Assoc J1974; 114:205.
26.
FirestoneP, DaveyJ, GoodmanF, et al. The effects of caffeine and methylphenidate on hyperactive children. J Am Acad Child Psychiatry1978; 17:445-56.
27.
SpragueRL, SleatorEK. Methylphenidate in hyperkinetic children; differences in dose effects on learning and social behaviour. Science1977; 198:1274.
28.
WaldeckB.Some effects of caffeine and aminophylline on the turnover of catecholamines in the brain. J Pharm Pharmacol1971; 23:824.
29.
GagnonDJ, BoucherP.Effects of caffeine on central monamine neurons. J Pharm Pharmacol1972; 24:155.
30.
SnyderS, MeyerhoffJL. How amphetamine acts in minimal brain dysfunction. Ann NY Acad Sci1973; 205:310.
31.
JanowskyDS, El-YousefMK, DavisJM, et al. A cholinergic-adrenergic hypothesis of mania and depression. Lancet1972; 2:632.
