A monoamine oxidase hypothesis for the cause of attention deficit hyperactivity disorder has recently been established (Shekim et al. 1986). To test this, moclobemide, a new and reversible inhibitor of monoamine oxidase-A, was administered to 12 children between the ages of 6 and 13 years, diagnosed as attention deficit hyperactive according to DSM III-R, in a 4-week study. All had previously discontinued treatment with methylphenidate due to side-effects. A 40% improvement in parental assessment of children's behaviour occurred among those who received moclobemide as outpatients, and a 31% improvement among the five in-patients. There was a general increase in concentration and attention span at the end of the trial, but mood changes and explosive behaviour continued to be present at a low level. Brain mapping after moclobemide treatment showed an overall reduction in frontal lobe delta activity. Moclobemide was well tolerated by these patients, although two complained of mild gastrointestinal disturbances during the first week of therapy.

The use of psychotropic drugs in childhood and adolescence has been the subject of intense debate during the last few years. Allegations about the excessive consumption and overprescription of these substances in younger age groups play an important role in the public discussion. In this situation it would be useful to present relevant data on the prescription volume of psychotropic drugs in childhood and adolescence. The present investigation comprises data of 1985 using the GKV drug index and the IMS prescription index. According to the authors' results the prescription volume of these drugs is significantly lower than estimated in previous pilot studies. Illustrating the prescriptions by means of a drug profile, type and prevalence of psychotropic medication in children and adolescents are clearly distinguished from those of other age groups by the greater use of homeopathics and phytopharmaceutics. Among the psychotropics the neuroleptics represent the largest group. In comparison with international drug prevalence studies the prescription volume of psychostimulants is extremely low in the Federal Republic of Germany.

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