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Biomedical subjects

R J Schain

Publications and source records attributed to R J Schain.

12 recordsLinked to original sources
PubMed1979

Long-term use and discontinuation of methylphenidate with hyperactive children.

The long-term effects of methylphenidate on the behavior and academic functioning of hyperactive children are described. 36 children having a positive response to methylphenidate entered a three-year follow-up study in which they were closely monitored physically, behaviorally and psychometrically. During this period 13 children spontaneously discontinued medication: there were no statistically significant differences between them and the children who continued medication in terms of age, IQ or ratings at initial interview. The greatest improvement in performance occurred in the early months of treatment, but was only partially maintained during long-term therapy and little further change occurred after medication was discontinued. The findings indicate that sustained improvement is related to factors other than continued medication, and they suggest that drug therapy should be regarded as a short-term intervention until more positive social and school behavior can be established.

Achievement↗
PubMed1979

Effects of methylphenidate on hyperactive children's ability to sustain attention.

The purposes of this study were to investigate the attentional characteristics of hyperactive children, the relationship of subjective and objective measures of these characteristics, and the effects of methylphenidate on these measures of attention. Forty-five hyperactive children, ages 6 to 10 years, were entered into an 18-week study of the effects of methylphenidate (Ritalin) on attention. Measures included rating scales completed by teachers and parents and a vigilance task. All measures reflected significant changes during the period of investigation. Attention and behavior were significantly improved under drug conditions and significantly worsened when methylphenidate was discontinued. However, only performance on the objective measure returned to predrug levels; final off-drug parent and teacher ratings remained improved over initial reports. Parent ratings of behavior, and specifically of children's ability to attend, were unrelated to equivalent teacher ratings. Teachers' ratings of attention correlated significantly with performance on the vigilance task, discriminated between on-drug and off-drug conditions, and discriminated between children who obtained normal or near normal predrug scores on the objective measure and those who performed poorly on this measure. Methylphenidate improved attentional performance for children who had poor predrug scores on the vigilance task, but did not produce a statistically significant change on the scores of children with normal predrug performance.

Attention↗
PubMed1979

Problems with the use of conventional anticonvulsant drugs in mentally retarded individuals.

Special problems in the use of anticonvulsant agents in the mentally retarded are reviewed. Effects of barbiturates on mental abilities and of phenytoin on facial appearance are especially undesirable side effects of these agents in mentally retarded individuals. Careful consideration should be given to selection of anticonvulsants that minimally interfere with the long-term rehabilitation of mentally retarded persons. The relationship of paroxysmal EEG abnormalities, episodic violence and hysteroepilepsy to epilepsy is discussed.

Adolescent↗
PubMed1977

Phenobarbital-induced brain growth retardation in artificially reared rat pups.

Phenobarbital was administered daily to rat pups during the period of their brain growth spurt. A new technique for artificially rearing rat pups, using chronic intragastric feeding cannulas, was used to prevent drug-induced undernutrition. Rats, receiving neonatal phenobarbital, experienced a marked interruption of early brain growth, although their body weights reflected normal growth.

Animals↗
PubMed1977

Carbamazepine as an anticonvulsant in children.

Forty-five children with major motor or psychomotor seizure disorders were treated with carbamazepine in place of sedative anticonvulsants (phenobarbital, primidone) because of chronic behavioral difficulties. A batter of measures believed to reflect attentional and perceptual abilities was administered initially and repeated 4 to 6 months later following the drug crossover. At the conclusion of the study, 37 of the 45 children were judged to be drug "successes"; that is, general alertness and attentiveness were improved, while seizures were adequately controlled. This study indicates that therapeutic regimens of carbamazepine are less likely to interfere with mental functions in children than are equivalent doses of sedative anticonvulsants.

Adolescent↗
PubMed1975

Minimal brain Dysfunction.

Because of the prevalence in our society of children labeled with the term minimal brain dysfunction; physicians who treat children must develop a point of view toward the syndrome and a working procedure for assisting affected children. An approach to this problem can be divided into two parts: detection of somatic disorders and comprehensive management of school problems. The detection of somatic disorders that may have produced or substantially contributed to the school problem requires conventional medical skills for recognition and treatment. Comprehensive management of school problems requires a broader approach by the physician; including counseling of the parents regarding adverse family interactions, advice about educational resources and consideration of the question of drug therapy for behavioral disorders. In all instances parents should be able to rely on the physician to act as a scientific source of guidance on the merits of the plethora of therapies directed toward the child with learning disorders. The ability to function competently in all of these areas will enable the physician to provide a service for children and their families that may profoundly affect their lives.

Attention Deficit Disorder with Hyperactivity↗
PubMed1975

Observations on effects of a central stimulant drug (methylphenidate) in children with hyperactive behavior.

Ninety-eight hyperactive children, ages 6 to 12 years, have been treated with methylphenidate or placebo under double-blind conditions. Only one of the 48 children receiving placebo (2%) was judged to be a drug success. Seventy-nine percent of the 94 children receiving methylphenidate were judged to be drug success at the end of the 16-week trial period. A wide range of dosage (0.2 to 1.9 mg/kg) was required for optimum drug effects. Drug failures were due either to appearance of withdrawn, apathetic behavior in the child (6 cases) or lack of evidence of drug effectiveness (14 cases). Overweight children did not respond well to medication even though milligram per kilogram dosage was equivalent to that in children who were categorized as drug successes. The most dramatic successes were seen in children who might be characterized as exhibiting "developmental hyperactivity," i.e., hyperactivity in the absence of other evidence of neurological or emotional disturbances. We conclude that a trial of stimulant drugs is clearly indicated in hyperactive children manifesting significant impairment of educational and social progress. Dosage adjustment and judgement of drug success or failure require regular reports from teachers and parents.

Birth Weight↗