Abstract

It is estimated that 0.5-1.4% of school-aged children in England and Wales have severe hyperactivity,1^,2 a syndrome characterised by impulsiveness, inattention and overactivity. In the UK, two CNS stimulants, methylphenidate and dexamfetamine (dexamphetamine), are licensed for treating childhood hyperactivity where non-drug measures alone have proved insufficient. In 1995, we concluded that behavioural and educational approaches should be first-choice steps in most children with hyperactivity, with stimulant drugs being reserved for children in whom the disorder is severe or who are resistant to non-drug treatments.2 Here, we reassess the place of stimulant drugs in the management of severe hyperactivity in children.