Impact of Long-Term Treatment of Methylphenidate on Height and Weight of School Age Children with ADHD

Abstract

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.

ADHD, Stimulant Treatment, and Growth: A Longitudinal Study

“…9,18 Although studies in the 1970s reported reductions in height in children treated with stimulant medication, 10,19 subsequent studies have been mixed, with some reporting growth reductions 16,[20][21][22] and others finding no significant growth changes. [23][24][25][26] Higher dosages of stimulants may cause more growth attenuation.…”

Chronic Treatment with Extended Release Methylphenidate Does Not Alter Dopamine Systems or Increase Vulnerability for Cocaine Self-Administration: A Study in Nonhuman Primates

“…In clinical literature, there has been considerable debate about the effects of stimulant therapy on growth rates. There have been reports of the suppression of the normal trajectory of height and weight gain with stimulant treatment (Safer et al, 1972;Zhang et al, 2010). A recent large multicenter study of the effects of extended release formulations of MPH reported significant suppression of growth rates for both height and weight over a 2-year treatment period, persisting over a 3-year follow-up (Swanson et al, 2007).…”

“…There is evidence for modest growth suppression (Safer et al, 1972;Zhang et al, 2010), although this is far from consistent. Some studies of MPH-treated children have reported reduced growth curves for both height and weight compared with age-matched controls (Swanson et al, 2007), whereas others reported no effects on growth (Biederman et al, 2010).…”

Exposure to methylphenidate during infancy and adolescence in non-human animals and sensitization to abuse of psychostimulants later in life: a systematic review

“…44,45 Finally, the third objective was to evaluate vulnerability to the reinforcing effects of cocaine after pre-exposure to MPH, using the self-administration paradigm. Overall, no differences were found between groups in the availability of D2/D3 or DATs following exposure to MPH during late infancy.…”