|
Home » Resources » Research Articles » Methylphenidate Related Growth Impairment
Methylphenidate
Related Growth Impairment
JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY
Volume 12, Number 1, 2002
KRISTIAN HOLTKAMP, M.D., BIRGITTA PETERS WALLRAF, M.D.,
STEFAN WÜLLER, M.D., ROLAND PFÄAFFLE, M.D., and BEATE HERPERTZ
DAHLMANN, M.D.
Growth deficit associated with stimulants in children
who have attention deficit hyperactivity disorder (ADHD) has long been
the subject of scientific discussion. More recent studies describe the
effects on the final height of children with ADHD who are treated with
methylphenidate (MPH) as only slight. There are only a handful of reports
of severe growth deficits attributed to MPH that are associated with
gastrointestinal side effects. We describe a 10¬year¬old boy
with ADHD and chronic asthma who underwent corticosteroid therapy and
developed an almost complete growth arrest during MPH treatment. Growth
hormone (GH) stimulation tests and measurement of GH dependent growth
factors point to the influence of MPH on GH secretion with subsequent
impaired growth. One may conclude that some children are at risk of
serious growth decrement when treated with MPH. The growth of children
should thus be monitored carefully, even if there are no alarming gastrointestinal
side effects from MPH. We found that the determination of growth velocity
was a sensitive marker for the evaluation of growth impairment in our
patient.
INTRODUCTION
STIMULANT ASSOCIATED GROWTH DEFICITS in children with
attention deficit hyperactivity disorder (ADHD) have long been a concern.
Safer and Allen (1973) described a significant decline in the weight
and height percentile of subjects receiving methylphenidate (MPH) compared
with an untreated group. Subsequent studies have revealed a mixed set
of findings. Some investigators have reported a connection between MPH
medication and height deficits (Klein et al. 1988; Safer and Allen 1973;
Spencer et al. 1992). Others have found no significant decreases in
height attributable to MPH (Hechtman et al. 1984; Kalachnik et al. 1982;
Spencer et al. 1996). In a recent study, Kramer et al. (2000) suggested
that the risk posed by stimulant medication to the growth of most children
is negligible but that in a few individuals the occurrence of gastrointestinal
side effects like nausea and vomiting is associated with a height decrease
in early adult age.
To read more of this article visit The
National Library of Medicine
|
