Effect of long-term treatment with stimulant medication on growth? [2]

FreeText:Reply on a comment on Ritalin (J Am Acad Child Adolesc Psychiatry 2006; 45:520-526). The study reported the lack of effect of either Ritalin or amphetamines on height and minimal effect on weight in children with ADHD. The comment stated that there may be a possible differential effect of stimulant in children who are treatment naive versus those with a history of chronic stimulant treatment. In reply, the authors of the study state that indeed no effect of either Ritalin or amphetamine was observed in terms of reducing height and weight z scores in their study. In contrast, the Multimodal Treatment Study of ADHD (MTA) observed that drug naive children were taller and heavier versus patients who had received stimulant treatment for a 2-year period (MTA Cooperative Group, 2004). If any effects of stimulants on growth were concentrated in the initial 1 to 3 years of treatment and the patients in the study contained a large number of patients who already had been exposed to stimulants, then no further slowing of growth rates in subsequent years would have been observed. Furthermore, the authors of the study state that related to this issue is whether children with ADHD were actually larger than average relative to age-matched healthy controls before medication treatment (MTA Cooperative Group, 2004). The authors agree that future studies on the effects of stimulants on growth should rigorously control for the effect of prior treatment status.

Indications:Unspecified number of patients with attention deficit hyperactivity disorder.

Patients:-

TypeofStudy:Letters to the editor.

DosageDuration:-

Results:-

AdverseEffects:Unspecified number of patients had weight reduction.