The knowledge and attitudes of children receiving stimulant medication for attention deficit hyperactivity disorder were investigated at the Division of Ambulatory Pediatrics, Children’s Hospital, Boston, MA. Of 45 respondents and parents who completed separate questionnaires concerning how they felt about receiving stimulant medication, 89% of the children felt that the medication was helpful and 78% either approved or were indifferent to its use. Improved concentration and improved ability to sit still in the classroom were the most frequently reported benefits. Difficulty getting to sleep and decreased appetite were the most common side effects, and at least one negative aspect of therapy was reported in 82.2% of children. Only five children (11%) would stop taking stimulant medication if they could; these were more likely to perceive medication as unhelpful if they were receiving standard methylphenidate rather than a long-acting preparation. The authors conclude that children’s perspectives on medication should be elicited directly and a sustained release medication may be more acceptable to children with ADHD. [1]

COMMENT. The need to take stimulant medication while at school may be an important factor in the child’s attitude, and compliance for prescribed therapies can be improved by decreasing the complexity or inconvenience of the therapy. Previous studies have shown that standard methylphenidate is superior to sustained release preparations on measures of disruptive behavior and cognitive performance. In contrast to advertising material, the effects of sustained release and standard methylphenidate were not equivalent. Pemoline or slow release dextroamphetamine were recommended in preference to sustained release methylphenidate, if a single daily dose sustained effect is required [2] (Ped Neur Briefs Oct 1987).