Effects of Atomoxetine on Height and Weight in Korean Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Retrospective Chart Review

Abstract

Objective We aimed to investigate the long-term effects of atomoxetine on growth in Korean children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods The medical records of 82 subjects (mean age, 9.0±2.0 years; 64 boys) with ADHD treated with atomoxetine for at least 1 year at the Department of Psychiatry at Asan Medical Center were retrospectively reviewed. Height and weight data were prospectively obtained and retrospectively gathered and converted to age- and gender-corrected z scores using norms from Korean youths. Growth changes were analyzed using random coefficients models with changes in height or weight z scores as the dependent variables. Results Height z scores significantly decreased during the treatment period (β=-0.054, p=0.024). Height z scores decreased during the 1st year of treatment (β=-0.086, p=0.003), but did not change after the 1st year. Weight z scores did not change significantly during treatment (β=0.004, p=0.925). Conclusion Our results suggest that long-term atomoxetine treatment may be associated with deficits in height growth in Korean youths, although this effect was minor and tended to be attenuated over the first year. Because of the limitations of this study such as retrospective design and selection bias, further prospective studies are needed.

The effects of atomoxetine on weight, height, and body mass index in Turkish children and adolescents with attention deficit hyperactivity disorder

“…There was a significant effect between only boys and differences in height-SDS z-scores and weight-SDS z-scores between baseline and follow-up, but in the regression analysis, gender did not have an effect on predicted difference and final anthropometric values. Our results were coherent with the findings of the study by Kweon et al [22] which did not find interaction between boys and girls in the effect of Atx on growth [22]. Also Biederman et al [25] showed the effect of emotional disorders on z-scores which are greater weight in girls and with smaller height in boys [25].…”

“…It is unclear if and in what dimension comorbidities have an influence on weight problems in examined patients with ADHD. A significant decline between baseline and followup weight and the significant decrease in the z-score for height were observed in the total sample, but the decline was not observed in all subgroups supporting the current literature that has evaluated the clinical importance of reduced parameters [22]. Several mechanisms explain the reason of Atx on height and weight.…”

“…Nevertheless, in most previous studies, there has been no difference between the effect of atomoxetine and target height reduction in children and adolescent with ADHD [11,26]. On the other hand, these results are not coherent with previous studies that concluded that Atx may be associated with the reduction of growth velocity and target height [22,27]. In contrast to the studies mentioned above, the reason of controversial results could be due to differences in study designs including those of retrospective or prospective, self-reported evaluation, ADHD subtypes, phone interviews, other medication use, comorbidities, etc.…”

Effect of Atomoxetine on Behavioral Difficulties and Growth Development of Primary School Children with Attention-Deficit/Hyperactivity Disorder: A Prospective Study

“…Methylphenidate is a short-acting stimulant that is well tolerated in the short term. It reduces height and weight in the long term [ 10 , 11 ], while the short-term effects of atomoxetine on growth development are not well documented. Long-term atomoxetine treatment may be associated with deficits in height growth [ 10 ].…”

“…It reduces height and weight in the long term [ 10 , 11 ], while the short-term effects of atomoxetine on growth development are not well documented. Long-term atomoxetine treatment may be associated with deficits in height growth [ 10 ]. In addition, some studies have indicated that atomoxetine might have additional side effects beyond norepinephrine reuptake inhibition.…”