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THE BEHAVIOR CHARLES BY The BRADLEY, use of benzedrine carbinamine) as considerable available describing cal reactions been upon of comment. its effect the A of to drug The subject,8 studies facilities of of without The this intelligence, the has and undertaken with being and the psychological appears some of to have the changes of children adapted to a laboratory 12 disorders. the conditions patients under theochil- Pendleton controlled resident behavior Emma admirably under distractions only majority now psychologito have studied sort at the are artificial neurological since are other are of a type which might in certain behavior problem behavior deals any recently reports and Since of institution the hospital presenting were children’s introducing ation. of mood children. methyl benzyl stimulant number the therapy by benzedrine in adults prove of clinical value observation R. I. PROVIDENcE, but so far no one appears neglected dren, the present Bradley Home. EAST system upon behavior children a generally produced retically nervous of adults,’T effect response M. D., RECEIVING (beta-aminopropylbenzene; a central aroused its OF CHILDREN BENZEDRINE.* situ- of normal years Since of such age chil- dren require prolonged treatment the hospital setting has been designed to provide most of the desirable features of an outside community, including school, scouting activities, sports, etc. Although each child busies himself with a very natural sort of daily activity, he is under constant observation, and careful records of his behavior are are quite To dren, observe 30 a variety child * kept unaware as a matter of routine. of this close scrutiny. In general, the the effect of benzedrine upon the behavior already resident in the hospital, suffering behavior disorders, were selected for study. patients of patients, of in this group the Emma had already Pendleton been ; Bradley under observation for chilfrom Every at least Home. Portions of this study were made possible for Research in Dementia Pnecox founded Northern Masonic Jurisdiction, U. S. A. by a grant from by the Supreme the Committee Council, 330, 578 EFFECTS a month. OF Twenty-one of sexes boys and that noted approximating The ages ranged passed their 13th BENZEDRINE ON nine girls for [Nov. BEHAVIOR were studied, all admissions from 5 to 14 years, two birthday. The children’s this to the boys and behavior ratio hospital. one girl disorders having were severe enough to have warranted hospitalization, but varied siderably. They ranged from specific educational disabilities, secondarily disturbed school behavior, to the retiring schizoid on the the one hand other. the so-called In “normal” of to nurses for a period this nurse’s ciation with with taken his the second benzedrine the observation teachers, without During Later egocentric was 10 records was Possibly the most benzedrine therapy of these patients. fashion. Different in age and school in school a definite general child quite recording child administered of his those of the week as control periods interest and each was recognition of her week of observation “drive” school period, work. Speed and to behavior of personally on within behavior observed each during special function a daily morning patient this week upon were prior and the week following, for this particular child. SCHOOL of epileptic in range. routine and aggressive, intelligence of three weeks by a special psychiatric nurse. Because customary duties had already involved daily close assoall of the children, she was able to observe carefully patient time. the patients’ addition by ward each and The conwith child at this dose arising. compared which were PERFORMANCE. striking change occurred in in behavior the school during activities the of week many Fourteen children responded in a spectacular teachers, reporting on these patients, who varied accomplishment, agreed that a great increase of material was noted to accomplish often to spend immediately. as extra much time as There possible completing appeared during the additional of comprehension and accuracy of performance were cases. Insight into school improvement was generally present, though few of the children attributed it to the medication they had received earlier in the day. The improvement was noted in all school subjects. It appeared promptly the first day benzedrine was given and disappeared on the first day it was increased discontinued. in most 1937] CHARLES There and one show were 15 child who some in their children did not of school Two their children behavior EMOTIONAL In discussing emotional in many of these children external symptom children in their responded emotional of that In this of a child were in group terested 15 respects no response whose some to the in was in drug surroundings. were of swings had Such become to both of them gave point of mild diminished. irritabehavior. more placid to become more inbecame changes, responses 30 subdued was an their domineering however, performance common an it was accomthe appearance expressed of the drug they seemed that of the distinctly cases this had who aggressive, school emotional Seven to the even mood children in mind essentially Fifteen by becoming Clinically in all by noisy, improved children variety maladjustment. under the influence Coincidentally, the children. being, in other responses it must be kept the conduct disorder was emotional activities in their paralleled A no change the social viewpoint. In many of well-being; but superficially group Such children and easy-going. seven changes showed RESPONSE. to benzedrine responses. improvement from panied by a sense bility a change, eight did 15, temporary others showed the or elsewhere. school was so striking Of other Five although altered. show age. accompanying characteristics. performance, distinctly not improvement, personal school who was 579 BRADLEY noted by no means as only above groups. were noted evidence in only euphoria. the remaining of a sense Although of well- questioning the children in regard to their subjective feelings was studiously avoided in all instances, spontaneous remarks such as, “I have joy in my stomach,” I feel fine and can’t seem to do things fast enough “ today,” know “I feel peppy,” it, it is done,” and these patients and superficially showed “I start “I feel a widening at least, to make fine,” of interest a diminished my seemed bed and significant. in things tendency were more easily aroused. Two others were I All of around to be them, preoccupied with themselves. Three other patients were observed to cry much more ing the week that they received benzedrine, as though tions before noted easily durtheir emoto wear 580 OF BENZEDRINE EFFECTS worried expressions one child ing more As quite of the entire hyperactive, was the changes appeared case appeared as soon foreign with alterations A drug ever, from his whose to intellectual came usually A few a little the hospital. activity not Only explained efficiency of was of these Another creased, go out of agitation, included expressed for fear he patients some children who with in their who became in school feeling might of run the and noisy mentioned among and decrease how- and of became motor emotionally elation daily possibly be- routine about increase in motor three boys became on the talked with ward. One defiant. as having three agitation away, be ex- children, than walked, as to interfere ran about rather were so stimulated work naturally In motor activity er se apart as shown by his mood and responded daily previously also may patients showed an other changes. These in general the child of treatment activity. particularly three by their boy, and sion, our who active, to the point rapidly, and active more the of those more motor in the all these and dis- CHANGES. to measure behavior In noted Only by becom- performance, of a stimulant in difficult general activity. was subdued. is that changes appearance. medication in school PSYCHOLOGICAL action produce it is extremely the individual’s activity usual to the irritable. promptly on the first day as the drug was stopped. OTHER pected to their responded aggressive and 30 [Nov. BEHAVIOR ON whose a worried motor expres- activity in- and worry, was afraid was at times fearful to of death. He had not manifested such symptoms before. It will be noted that comparatively little mention has been made of the patients’ subjective feelings under the influence of benzedrine. Personal questioning of any child was deliberately avoided so as not to influence his behavior artificially through suggestion or by indicating that of subjective taneous been he was responses remarks which the object are therefore of particular limited the children made, In and Records occasional which have sponalready mentioned. PHYSIOLOGICAL changes attention. to the view 1, of 6, 11, the 12 observations may follow OBSERVATIONS. of others benzedrine that therapy, certain such physiological routine cx- 1937] CHARLES aminations as would not artificially out during these studies. given blood pressure was during each day on about cant change in the On influence the noted the for as first four night or two. nights. Loss morning of by meal the were count present was Agitation and irritability, of in adults, were observed to in but one Psychological effects changes hours, with 30 to dose sleep suggested more day falling asleep noted children at the nausea and epigastric of by rest. overdosage EFFECT. over in the a period hours individuals the full the continued permanently when relieved characteristic or more instances administration, disappeared start dose usually to appear i6 in a few In all for child. disappearance that of the and be OF disturbances persistent. first and of majority 45 minutes after oral ingestion of the were at their height during the second gradual Occasional were as a result conventional by malaise, DURATION children havior of the or two, said no signifi- appreciably influsleep was mildly dis- time in a few an hour was level remained awake to a late hour and nausea at the time of the expressed for were inconstantly not nocturnal One patient of appetite uniformly persisting but There was carried which or hemoglobin in the Intolerance distress, were benzedrine moderately weight a delay observed experiment. behavior of the children. half erythrocyte evidenced doses to rise of the week’s treatment. Body enced. In six of the 30 children turbed, 581 BRADLEY daily as soon as the of 6 to after of the drug. and the Bethird hours. 12 morning stimulating effect was effects appeared on the throughout drug was the week discontinued. DOSAGE. The single children of the to produce consequences. who doses on the basis found, few 30 morning children, changes All were of of that the objects benzedrine giving 20 gradually mg. in behavior of this sulfate was upon increasing generally without study trial a satisfactory undesirable received arising. It doses was to a amount physiological given a trial dose the children studied were then mg., but in, eight instances this resulted in gastrointestinal distress sufficient to color all the child’s reactions. These eight children were therefore given 10 mg. as their daily dose during the of 20 582 EFFECTS OF BENZEDRINE ON [Nov. BEHAVIOR week. Two of them showed no response of any sort on this amount, suggesting that the largest dose they could tolerate was therapeutically ineffectual. The remaining patients all received daily doses of 20 mg., except one boy who tolerated 30 mg. very well and received that amount. There was no apparent relationship between the children’s ages or weights and their reaction to benzedrine. COMMENT. Possibly by the the use formance of striking and most change was we they were half that note dealt very small duce a greater bined would efforts have with been did that so gratifying is evident However, As far as the performance, quantity were since of output school for in most It appears paradoxical that a drug produce subdued behavior in half however, system that have personality individual basis pro- than the com- setting, not the viewpoint. of school that a stimulating whole group of mood or in of benzedrine acceleration changes school impressed favorably an dose individual of comprehension, nervous intelligence any degree the shared subjects by changes per- drug children in school, in spite of ways to the medication. all in mind, for a practical this were central of good in a most favorable to the teachers, had speed borne more performance favorable improvement. improvement teachers on daily response in other half of the group showing notable degree in the school is the were aside from the fact at least half of the not show this striking most of them responded cerned either from reason per- This school progress. Moreover they specially trained, sympathetic staff working demoralizing plausible about school attention a single in of a capable been all but entirely formance was used. pupils see improvement improvement No To patients their where brought improved children. adequate their groups. the these receiving disorders which might affect were already in a school teachers in behavior the remarkably approximately when that spectacular of benzedrine fact Only to was a con- in arithmetic of accuracy and affected. known of the portions inhibition stimulation of these portions might indeed ture of reduced activity through increased of to be a stimulant should children. It should be the as their higher levels function, produce voluntary of the and the clinical control. that picPre- 1937] 583 BRADLEY CHARLES . sumptive evidence that this may be the case is suggested by electroencephalographic studies,U which formed part of the clinical examination in 20 of our 30 patients. Definite abnormalities of the brain rhythms were noted in II of these children, eight of whose records the showed “seizure the “spike waves” seen in some children resembles that and slow wave” in patients whose erratic, of epileptic form with irritable patients.15’ characteristic mal and It may 16 of epilepsy.14 and aggressive behavior petit be significant that all but one of these children with “seizure waves” became distinctly subdued under the influence of benzedrine. Since it has also been noted that “slow waves” in the electroencephalogram are likewise present in a number of conditions where consciousness is impaired, it has impaired been cortical suggested functions.17 ing drug like benzedrine activity and alleviate Further studies There ing into are, the havior vary problem. ability these relationship ventional in this between series a child’s reaction type, of the attractive factors enterany child’s be- fact that correlation preliminary seems intelligence sex, and vari- observations little to benzedrine age, children of this to be very response of cortical therefrom. possible of of the From characteristics impaired this. awaits there a stimulat- resulting understanding factors. indicates that this many other manifestation to benzedrine many clinical condition, disorder appearance postulate to confirm Complete children 30 to arouse necessary response with tend behavior of course, a great genesis and clinical in their the are their might may any that One past and history, special mental of apparent the con- physical abilities or disabilities. In spite patients, and its prolonged to await the apparent use in the more results low hands complete knowledge before recommending its clinical Presumably the uncomfortable, gastrointestinal symptoms the drug cian. The factors involved many and varied that adequately 38 A of they not trained be in child of problem necessarily accompany only small overdosage by the behavior competently psychiatry. group as evidenced it seems action though children’s can the in behavior be administered in in this of the drug observers,6’ use which that physicians should obtained toxicity of other experienced disorders evaluated of by wise benzedrine children. dangerous, indicate physiare only so by 584 EFFECTS Any relief well in every BENZEDRINE use indiscriminate might should OF mask case of benzedrine reactions receive ON of to produce etiological adequate [Nov. BEHAVIOR symptomatic significance which attention. SUMMARY. The who psychological received reactions benzedrine sulfate of 30 behavior for one week was a spectacular improvement the children. A large proportion subdued without, of other variety in school performance of the patients became losing interest in their children observed. There in half of emotionally surroundings. A behavior changes were also noted. Dosage, responses, and duration of effect of the drug are disit is suggested that its use in the treatment of children unfavorable cussed, however, problem were and with behavior child psychiatry. definite disorders be supervised by physicians trained in Hypertension produced i6, 1936. sulfate on mood and fatigue Neurol. Psychiat., 36: 8i6, with ben- for neurologic disorders. BIBLIOGRAPHY. i. Peoples, S. A., and zedrine. Lancet, Myerson, A.: Effect Guttmann, ii7, I: E.: May of benzedrine in normal and in neurotic persons. Arch. Oct. 1936. 3. Davidoff, E. M.: A clinical study of the effect of benzedrine therapy on self-absorbed patients. Psychiat. Quart., 10:652, Oct., 1936. 4. Sargant, W., and Blackburn, J. M.: The effect of benzedrine on intelligence scores. Lancet, 2 1385, Dec. 12, 1936. 5. Carlisle, C. L: Use of benzedrine sulphate in catatonic stupors. Med. Bull. Veterans’ Admin., 13:224, Jan. 1937. 6. Nathanson, M. H.: The central action of beta-anilnopropylbenzene. J. A. M. A., io8: 528, Feb. 13, 1937. 7. Wilbur, D. L, MacLean, A. R., and Allen, E. V.: Clinical observations on the effect of benzedrine sulphate. Proc. Staff Meetings Mayo Clin., ‘2: Feb. 17, 1937. & Darrow, C. W.: Psychological effects of drugs. Psychol. Bull., 26:527, 2. , 1929. . Bradley, C.: A children’s hospital and behavior J. A. M. A., io7: 6o, io. ii. Aug. 29, 1936. this study kindly sulfate for supplied by Smith, French Laboratories, Philadelphia, Pa. Myerson, A., Loman, J., and Daineshek, W.: Physiologic benzedrine and its relationship to other drugs affecting nomic nervous system. Am. J. Med. Sc., 192: 560 Oct. Benzedrine A Kline and effects of the auto1936. 1937] iz 13. 14. CHARLES Anderson, E. W., and Scott, W. C. M.: Cardiovascular effects of benzedrine. Lancet, 2 1461, Dec. 19, 1936. Jasper, H. H., and Andrews, H. L: Human Brain Rhythms. I. Recording Techniques and Preliminary Results. J. Gen. Psychol., 14:98, 1936. Gibbs, F. A., Davis, H., and Lennox, W. G.: The electroencephalogram in epilepsy and conditions of impaired consciousness. Arch. Neurol. Psychiat., 15. i6. 17. BRADLEY : 1133, Dec. 1935. Solomon, P., Jasper, H. H., and Bradley, C.: Studies in behavior problem children. Arch. Neurol. Psychiat. (In press.) Kiene, H. E., and Solomon, P.: Why people misbehave. Rhode Island Med. J., o: 8, April 1937. Davis, H.: Some aspects of the electrical activity of the cerebral cortex. Cold Spring Harbor Symp. Quant. Biol. 4: 285, 1936.