Effects of long-term psychostimulant medication on growth of children with ADHD

Dopamine-Related Genotypes and the Dose–Response Effect of Methylphenidate on Eating in Attention-Deficit/Hyperactivity Disorder Youths

“…Little is known about which children are most at risk for persistent anorexia and weight loss during treatment with stimulants like MPH because there are no prospective randomized studies that have identified phenotypic (e.g., age, gender) or medication-related (e.g., type of stimulant, dosing schedule, treatment duration) moderators for increased susceptibility to stimulant-induced anorexia and weight loss (Poulton 2005). Regardless of its duration, anorexia (and associated weight loss) is one of the leading reasons for dose reduction or discontinuation of stimulant therapy (Efron et al 1997;Wigal et al 2006;Zachor et al 2006), with up to 12% of subjects stopping medication due to appetite loss (Zachor et al 2006). In the Multimodal Treatment Study of Children with ADHD (MTA), which used a ½ dose in the afternoon, anorexia was still the most common reason for a dose reduction, leading 10% of subjects to lower their dose (Vitiello et al 2001).…”

Effect of Stimulants on Growth of ADHD Children: A Critical Review

“…Although these effects attenuate over time and some data suggest that ultimate adult growth parameters may not be affected (Faraone et al, 2008). This was confirmed also by the study of Zachor et al (2006), who analyzed the effects of long-term psychostimulant medication on growth parameters in children with ADHD. There were 89 children measured at baseline in the interval of 3, 6, 12, 24, and 36 months.…”

Stimulants and growth in children with attention-deficit/hyperactivity disorder

“…In order to determine whether a relationship exists between stimulant intake and growth in children with ADHD, the first question to be asked is how un-medicated children with ADHD compare in size to control subjects. Although some studies found un-medicated children with ADHD to be of normal height [1][2][3], weight [1,2] and body mass index (BMI) [2,4]; several, in fact the majority, of studies indicated that un-medicated children with ADHD are actually taller [5][6][7][8][9] and heavier than normal [3,[5][6][7][8]10]. These findings, therefore, contradict the initial suggestion [11] that height deficits in ADHD may be mediated by the disease itself.…”

“…Most studies agree that stimulant medication causes an attenuation of height velocity, specifically during the first few years of treatment [1,[6][7][8][14][15][16][17][18][19][20][21][22][23][24], with an estimated height deficit of about 1 cm/year for the first 3 years [8]. Although some studies suggest that, in most cases, this stunting of linear growth normalises after approximately 3 years of treatment and that adults with ADHD do not differ significantly in height from control subjects [1,4,8,12,22], others are of the opinion that no tolerance to the height suppressant effects of stimulants develops [19] and no evidence of growth rebound exists in these subjects [6].…”

“…Regarding the effect of stimulant medication on weight, the consensus appears to be that adrenergic stimulants can cause a significant decrease in weight, specifically during the first few months of treatment [3][4][5][6][7][8]10,14,15,19,21,22,24]. However, this effect appears to be more pronounced in children that are over-weight to begin with [10,12].…”