Editing Paradoxical reaction (section)

===Barbiturates===
[[Phenobarbital]] can cause hyperactivity in children. This may follow after a small dose of 20&nbsp;mg, on condition of no phenobarbital administered in previous days.<ref>{{cite web | title = Professional Health Care Providers | url = http://professionals.epilepsy.com/medications/p_phenobarbital_commonside.html | work =  Epilepsy Foundation }}</ref> Prerequisite for this reaction is a continued sense of tension. The mechanism of action is not known, but it may be started by the anxiolytic action of the phenobarbital.{{citation needed|date=June 2024}}

[[Barbiturate]]s such as [[pentobarbital]] have been shown to cause paradoxical hyperactivity in an estimated 1% of children, who display symptoms similar to the hyperactive-impulsive subtype of [[attention deficit hyperactivity disorder]]. Intravenous [[caffeine]] administration can return these patients' behavior to baseline levels.<ref>{{Cite journal|last1=Rubin|first1=Joan T|last2=Towbin|first2=Richard B|last3=Bartko|first3=MaryBeth|last4=Baskin|first4=Kevin M|last5=Cahill|first5=Anne Marie|last6=Kaye|first6=Robin D|date=2004|title=Oral and intravenous caffeine for treatment of children with post-sedation paradoxical hyperactivity|journal=Pediatric Radiology|volume=34|issue=12|pages=980–984|doi=10.1007/s00247-004-1303-8|issn=1432-1998|pmid=15365651|s2cid=19473461}}</ref> Some case reports postulate a high rate (10-20%) of paradoxical response to anesthesia in ADHD patients, though this has not been objectively corroborated in controlled studies.<ref>{{Cite journal |last1=Langguth |first1=Berthold |last2=Bär |first2=Rüdiger |last3=Wodarz |first3=Norbert |last4=Wittmann |first4=Markus |last5=Laufkötter |first5=Rainer |date=August 2011 |title=Correspondence (letter to the editor): Paradoxical Reaction in ADHD |journal=Deutsches Ärzteblatt International |volume=108 |issue=31–32 |pages=541; author reply 541-2 |doi=10.3238/arztebl.2011.0541a |issn=1866-0452 |pmc=3163785 |pmid=21886668}}</ref>