Stimulant-associated growth deficits in children with attention deficit hyperactivity disorder (ADHD) have long been a concern. We chose 146 school age children diagnosed with ADHD being treated with methylphenidate (MPH) and 29 drug-free ADHD children, and followed them up for 2-4 years. We recorded the changes in height and weight after long-term methylphenidate treatment and analyzed the influence of confounding factors to growth in height, weight, and height velocity. The change of the gap between patients' height and mean height in the methylphenidate group was -1.86+/-0.82 cm ( P<0.001); in controls it was -0.26+/-0.51 cm ( P<0.05). The changes of height standard deviation score (SDS) in the methylphenidate group and controls were -0.14+/-0.23 SD ( P<0.001) and +0.05+/-0.10 SD ( P<0.05), respectively. The differences between the 2 groups were significant ( P<0.001). Both correlation and regression analyses indicated that the duration of treatment contributed significantly to the variance in change of height ( P<0.001). The height velocity was significantly attenuated in the first year. The change of the gap between the patients' weight and weight for height after methylphenidate was -0.14+/-1.25 kg ( P>0.05). From this study, a small but significant deceleration of height velocity has been identified as a long-term side effect of methylphenidate, the magnitude of the height deficit is related to the duration of treatment. Methylphenidate had no significant influence on weight and BMI values.

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