ADHD - An Illustrated historical overview

Are drugs enough? G iven its sedative effects, potas- sium bromide was among the first medications used to alleviate the bur- den of ADHD like symptoms. With the seminal experiments of Charles Brad- ley, amphetamine sulfates were intro- duced as treatment options, as were later more refined psychostimulants. Additionally, several other agents have been tested in adult studies, among them bupropion, clonidine, guanfa- cine, modafinil, pargyline, MAO-B-in- hibitors and l-deprenyl (selegiline). As controversy remains about the use of psychostimulants in children, other valid treatment options include therapies and measures directed to improve behaviour, social skills and environmental aspects. Such com- prehensive approaches have been advocated throughout the history of therapeutic options and ultimately gained ground with the works of Stel- la Chess in the 1960s and of Virginia Douglas („Are drugs enough?“) in the 1970s. Further support came from Su- san Campell, a colleague of Douglas at Montreal´s McGill University, and interesting contributions regarding classroom environment were provid- ed by Teodoro Ayllon and his group. Their suggestions included parent counselling and guidance, special re- quirements for educational staff and classroom management, cognitive training programs for children to im- prove cognitive tasks, social perfor- mance and disruptive behaviour, and psychotherapy. They stressed self- evaluation and self-control of affected children, and looked to behavioural alternatives to control hyperactivity, an approach more valid than ever for those interested in long-term solu- tions for treating children with ADHD.