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Levoamphetamine vs Dextroamphetamine in Minimal Brain Dysfunction: Replication, Time Response, and Differential Effect by Diagnostic Group and Family Rating

Levoamphetamine vs Dextroamphetamine in Minimal Brain Dysfunction: Replication, Time Response,... Abstract • Double-blind crossover randomized Latin square comparison of placebo, dextroamphetamine, and levoamphetamine in 31 consecutively diagnosed children with minimal brain dysfunction (MBD) replicated a smaller nonrandom study. Both isomers showed significantly more benefit than placebo but were not significantly different from each other. Dextroamphetamine showed a nonsignificant trend of superiority over levoamphetamine. Of 25 subjects who responded well to drugs, three responded only to levoamphetamine, five only to dextroamphetamine, and 17 to both. This study seems to confirm the efficacy of levoamphetamine In MBD. An unsocialized aggressive subgroup (308.4) showed a nonsignificant trend for levoamphetamine superiority, in contrast to the hyperkinetic (308.0) and overanxious (308.2) subgroups. Those who responded best to levoamphetamine tended (not significantly) to be from poorer functioning families. Parents' ratings, but not teachers' or psychiatrists' ratings, showed significant placebo effect. References 1. Arnold LE, Wender PH, McCloskey K, et al: Levoamphetamine and dextroamphetamine: Comparative efficacy in the hyperkinetic syndrome: Assessment by target syndromes . Arch Gen Psychiatry 27:816-822, 1972.Crossref 2. Arnold LE, Kirilcuk V, Corson SA, et al: Levoamphetamine and dextroamphetamine: Differential effect on aggression and hyperkinesis in children and dogs . Am J Psychiatry 130:165-170, 1973. 3. Fish B: The "one child, one drug" myth of stimulants in hyperkinesis: Importance of diagnostic categories in evaluating treatment . Arch Gen Psychiatry 25:193-203, 1971.Crossref 4. Davids A: An objective instrument for assessing hyperkinesis in children . J Learning Disabilities 4:499-501, 1971.Crossref 5. Arnold LE, Smeltzer DJ: Behavior checklist factor analysis for children and adolescents . Arch Gen Psychiatry 30:799-804, 1974.Crossref 6. Conners CK: A teacher rating scale for use in drug studies with children . Am J Psychiatry 126:152-156, 1969. 7. Huestis R, Arnold LE, Smeltzer DJ: Caffeine versus methylphenidate and d-amphetamine in minimal brain dysfunction: A double-blind comparison . Am J Psychiatry 132:868-870, 1975. 8. Rie H: Hyperactivity in children . Am J Dis Child 129:783-789, 1975. 9. Snyder SH, Taylor KM, Coyle JT, et al: The role of brain dopamine in behavioral regulation and the actions of psychotropic drugs . Am J Psychiatry 127:199-207, 1970. 10. Snyder SH: Putative neurotransmitters in the brain: Selective neuronal uptake, subcellular localization and interactions with centrally acting drugs . Biol Psychiatry 2:367-389, 1970. 11. Coyle JT, Snyder SH: Catecholamine uptake by synaptosomes in homogenates of rat brain: Stereospecificity in different areas . J Pharmacol Exp Ther 170:221-231, 1969. 12. Harris JE, Baldessarini RJ: Uptake of [3H] catecholamines by homogenates of rat corpus striatum and cerebral cortex: Effects of amphetamine analogues . Neuropharmacology 12:669-679, 1973.Crossref 13. Bunney BS, Aghajanian GK: Electrophysiological effects of amphetamine on dopaminergic neurons , in Usdin E, Snyder SH (eds): Frontiers in Catecholamine Research . Oxford, England, Pergamon Press, 1973, pp 957-962. 14. Ferris RM, Tang FL, Maxwell RA: A comparison of isomers of amphetamine, deoxypipradol and methylphenidate to inhibit the uptake of tritiated catecholamines into rat cerebral cortex slices, synaptosomal preparations of rat cerebral cortex, hypothalamus and striatum and into adrenergic nerves of rabbit aorta . J Pharmacol Exp Ther 181:407-416, 1972. 15. Thornburg JE, Moore KE: Dopamine and norepinephrine uptake by rat brain synaptosomes: Relative inhibitory potencies of l- and d-amphetamine and amantadine . Res Commun Chem Pathol Pharmacol 5:81-89, 1973.Crossref 16. Walters JR, Bunney BS, Aghajanian GK, et al: Locus caeruleus neurons: Inhibition of firing by d- and l- amphetamine . Fed Proc 33:294, 1974. 17. Potil PM, Miller DD, Trendelenburg U: Molecular geometry and adrenergic drug activities . Pharmacol Rev 26:323-392, 1974. 18. Alles A: Comparative physiological action of the optically isomeric phenisopropylamines . Univ Calif Publication Pharmacol 1:129-150, 1939. 19. Yokel RA, Pickens R: Drug level of d- and l-amphetamine during intravenous self-administration . Psychopharmacologia 34:255-264, 1974.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Levoamphetamine vs Dextroamphetamine in Minimal Brain Dysfunction: Replication, Time Response, and Differential Effect by Diagnostic Group and Family Rating

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1976.01770030012002
Publisher site
See Article on Publisher Site

Abstract

Abstract • Double-blind crossover randomized Latin square comparison of placebo, dextroamphetamine, and levoamphetamine in 31 consecutively diagnosed children with minimal brain dysfunction (MBD) replicated a smaller nonrandom study. Both isomers showed significantly more benefit than placebo but were not significantly different from each other. Dextroamphetamine showed a nonsignificant trend of superiority over levoamphetamine. Of 25 subjects who responded well to drugs, three responded only to levoamphetamine, five only to dextroamphetamine, and 17 to both. This study seems to confirm the efficacy of levoamphetamine In MBD. An unsocialized aggressive subgroup (308.4) showed a nonsignificant trend for levoamphetamine superiority, in contrast to the hyperkinetic (308.0) and overanxious (308.2) subgroups. Those who responded best to levoamphetamine tended (not significantly) to be from poorer functioning families. Parents' ratings, but not teachers' or psychiatrists' ratings, showed significant placebo effect. References 1. Arnold LE, Wender PH, McCloskey K, et al: Levoamphetamine and dextroamphetamine: Comparative efficacy in the hyperkinetic syndrome: Assessment by target syndromes . Arch Gen Psychiatry 27:816-822, 1972.Crossref 2. Arnold LE, Kirilcuk V, Corson SA, et al: Levoamphetamine and dextroamphetamine: Differential effect on aggression and hyperkinesis in children and dogs . Am J Psychiatry 130:165-170, 1973. 3. Fish B: The "one child, one drug" myth of stimulants in hyperkinesis: Importance of diagnostic categories in evaluating treatment . Arch Gen Psychiatry 25:193-203, 1971.Crossref 4. Davids A: An objective instrument for assessing hyperkinesis in children . J Learning Disabilities 4:499-501, 1971.Crossref 5. Arnold LE, Smeltzer DJ: Behavior checklist factor analysis for children and adolescents . Arch Gen Psychiatry 30:799-804, 1974.Crossref 6. Conners CK: A teacher rating scale for use in drug studies with children . Am J Psychiatry 126:152-156, 1969. 7. Huestis R, Arnold LE, Smeltzer DJ: Caffeine versus methylphenidate and d-amphetamine in minimal brain dysfunction: A double-blind comparison . Am J Psychiatry 132:868-870, 1975. 8. Rie H: Hyperactivity in children . Am J Dis Child 129:783-789, 1975. 9. Snyder SH, Taylor KM, Coyle JT, et al: The role of brain dopamine in behavioral regulation and the actions of psychotropic drugs . Am J Psychiatry 127:199-207, 1970. 10. Snyder SH: Putative neurotransmitters in the brain: Selective neuronal uptake, subcellular localization and interactions with centrally acting drugs . Biol Psychiatry 2:367-389, 1970. 11. Coyle JT, Snyder SH: Catecholamine uptake by synaptosomes in homogenates of rat brain: Stereospecificity in different areas . J Pharmacol Exp Ther 170:221-231, 1969. 12. Harris JE, Baldessarini RJ: Uptake of [3H] catecholamines by homogenates of rat corpus striatum and cerebral cortex: Effects of amphetamine analogues . Neuropharmacology 12:669-679, 1973.Crossref 13. Bunney BS, Aghajanian GK: Electrophysiological effects of amphetamine on dopaminergic neurons , in Usdin E, Snyder SH (eds): Frontiers in Catecholamine Research . Oxford, England, Pergamon Press, 1973, pp 957-962. 14. Ferris RM, Tang FL, Maxwell RA: A comparison of isomers of amphetamine, deoxypipradol and methylphenidate to inhibit the uptake of tritiated catecholamines into rat cerebral cortex slices, synaptosomal preparations of rat cerebral cortex, hypothalamus and striatum and into adrenergic nerves of rabbit aorta . J Pharmacol Exp Ther 181:407-416, 1972. 15. Thornburg JE, Moore KE: Dopamine and norepinephrine uptake by rat brain synaptosomes: Relative inhibitory potencies of l- and d-amphetamine and amantadine . Res Commun Chem Pathol Pharmacol 5:81-89, 1973.Crossref 16. Walters JR, Bunney BS, Aghajanian GK, et al: Locus caeruleus neurons: Inhibition of firing by d- and l- amphetamine . Fed Proc 33:294, 1974. 17. Potil PM, Miller DD, Trendelenburg U: Molecular geometry and adrenergic drug activities . Pharmacol Rev 26:323-392, 1974. 18. Alles A: Comparative physiological action of the optically isomeric phenisopropylamines . Univ Calif Publication Pharmacol 1:129-150, 1939. 19. Yokel RA, Pickens R: Drug level of d- and l-amphetamine during intravenous self-administration . Psychopharmacologia 34:255-264, 1974.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Mar 1, 1976

References