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Neuropediatrics 2010; 41(2): 55-59
DOI: 10.1055/s-0030-1261893
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

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

H. Zhang1 , M. Du1 , S. Zhuang1
  • 1Department of Pediatrics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P. R. China
Further Information

Publication History

received 11.02.2010

accepted 11.06.2010

Publication Date:
26 August 2010 (online)

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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.

Key words

methylphenidate - ADHD - attention deficit hyperactivity disorder - height - weight

References

  • 1 American Psychiatric Association .Diagnostic and statistical manual of mental disorders. 4th edn. (DSM-IV) Washington: American Psychiatric Association; 1994: 100-105
    Google Scholar
  • 2 Greenhill LL, Halperin JM, Abikoff H. Stimulant medications.  J Am Acad Child Adolesc Psychiatry. 1999;  38 503-512
    CrossrefPubMedGoogle Scholar
  • 3 Kilgore BS, Dickinson LC, Burnett CR. et al . Impaired growth in hyperkinetic children receiving pemoline.  J Pediatr. 1979;  94 538-541
    PubMedGoogle Scholar
  • 4 Klein RG. Clinical efficacy of methylphenidate in children and adolescents.  Encephale. 1993;  19 89-93
    PubMedGoogle Scholar
  • 5 Lisska MC, Rivkees SA. Daily methylphenidate use slows the growth of children: a community based study.  J Pediatr Endocrinol Metab. 2003;  16 711-718
    CrossrefPubMedGoogle Scholar
  • 6 Mattes JA, Gittelman R. Growth of hyperactive children on maintenance regimen of methylphenidate.  Arch Gen Psychiatry. 1983;  40 317-321
    PubMedGoogle Scholar
  • 7 Poulton A, Cowell CT. Slowing of growth in height and weight on stimulants: a characteristic pattern.  J Paediatr Child Health. 2003;  39 180-185
    CrossrefPubMedGoogle Scholar
  • 8 Ranke MB, Blum WF, Bierich JR. Clinical relevance of serum measurements of insulin-like growth factors and somatomedin binding proteins.  Acta Paediatr Scand Suppl. 1988;  347 114-126
    PubMedGoogle Scholar
  • 9 Rosenfield RL. Somatic growth and maturation. In: DeGroot LJ, Besser GM, Cahill GF Jr, eds, Endocrinology. Philadelphia: WB Saunders; 1989: 2242-2282
    Google Scholar
  • 10 Safer D, Allen R, Barr E. Depression of growth in hyperactive children on stimulant drugs.  N Engl J Med. 1972;  287 217-220
    CrossrefPubMedGoogle Scholar
  • 11 Safer D, Allen R. Factors influencing the suppressant effects of 2 stimulant drugs on the growth of hyperactive children.  J Pediatr. 1973;  51 660-667
    PubMedGoogle Scholar
  • 12 Safer D, Allen R, Barr E. Growth rebound after termination of stimulant drugs.  J Pediatr. 1975;  86 113-116
    PubMedGoogle Scholar
  • 13 Schertz M, Adesman AR, Alfieri NE. et al . Predictors of weight loss in children with attention deficit hyperactivity disorder treated with stimulant medication.  Pediatrics. 1996;  98 763-769
    PubMedGoogle Scholar
  • 14 Sirois PA, Montepiedra G, Kapetanovic S. et al . Impact of medications prescribed for treatment of attention-deficit hyperactivity disorder on physical growth in children and adolescents with HIV.  J Dev Behav Pediatr. 2009;  30 403-412
    CrossrefPubMedGoogle Scholar
  • 15 Spencer T, Biederman J, Wright V. et al . Growth deficits in children treated with desipramine: a controlled study.  J Am Acad Child Adolesc Psychiatry. 1992;  31 235-243
    CrossrefPubMedGoogle Scholar
  • 16 Spencer T, Biederman J, Harding M. et al . Growth deficits in ADHD children revisited: evidence for disorder-associated growth delays?.  J Am Acad Child Adolesc Psychiatry. 1996;  35 1460-1469
    CrossrefPubMedGoogle Scholar
  • 17 Spencer T, Biederman J, Wilens T. Growth deficits in children with attention deficit hyperactivity disorder.  Pediatrics. 1998;  102 501-506
    PubMedGoogle Scholar
  • 18 Yamei H, Zaifang J. et al .Shi Yong Er Ke Xue. 7th edn. Beijing: RenMinWeiSheng Press; 2002: 23-26, 37
  • 19 Zametkin AJ, Rapoport JL. Noradrenergic hypothesis of attention deficit disorder with hyperactivity; a critical review. In: Meltzer HY Psychopharmacology: The Third Generation of Progress. New York: Raven Press; 1987: 838-842
    Google Scholar

Correspondence

Hongyu Zhang

Department of Pediatrics

First Affiliated Hospital

Sun Yat-sen University

510080 Guangzhou

People's Republic of China

Phone: +86/20/8775 5766 8310

Email: drzhy@21cn.com

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