The use of dextroamphetamine to treat obesity and hyperphagia in children treated for craniopharyngioma.
BACKGROUND
Obesity and attention difficulties are known complications following surgical treatment for craniopharyngioma. Treatments to date have been largely disappointing.


OBJECTIVE
To examine the use of the central nervous system stimulant dextroamphetamine sulfate to regulate appetite and subsequent weight gain in children treated for craniopharyngioma.


METHODS
A multidisciplinary clinic specializing in pediatric brain tumors.


METHODS
Five consecutive patients with significant weight gain and poor attention following surgical treatment for craniopharyngioma were selected for the study.


METHODS
Children enrolled in the study were treated with dextroamphetamine, and growth, laboratory, and behavioral assessments were conducted for 24 months.


RESULTS
Mean +/- SD body mass index (weight in kilograms divided by height in meters squared) increased from 21 +/- 3.5 before the operation to 32 +/- 2.8 by the start of the protocol. Body mass indices remained stable throughout the protocol. No changes were observed in insulin levels or caloric intake, but the children were more active when taking dextroamphetamine. Parents noted a significant improvement in hyperactivity (mean +/- SD, 1.2 +/- 0.4 to 0.6 +/- 0.2; P =.05), scored with the Conners Parent and Teacher Rating Scales. Teachers noted a similar improvement.


CONCLUSIONS
During dextroamphetamine treatment, weight gain stabilized in children who had experienced obesity following surgical resection for craniopharyngioma. In addition, parents and teachers noted significant improvements in children's overall activity and attention. Further studies are needed to determine if the improvements are stable and if earlier intervention can prevent the initial obesity.
Inova Fairfax Hospital for Children, Fairfax, Va, USA
Patrick W
PW
Mason
Nicolas
N
Krawiecki
Lillian R
LR
Meacham
D000704:Analysis of Variance; D015992:Body Mass Index; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000517:prevention & control; D003397:Craniopharyngioma / Q000601:surgery*; D003913:Dextroamphetamine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006963:Hyperphagia / Q000188:drug therapy* / Q000209:etiology; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000188:drug therapy* / Q000209:etiology; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy*
D000697:Central Nervous System Stimulants; D003913:Dextroamphetamine