Effect of stimulants on height and weight: a review of the literature.
OBJECTIVE
Stimulant medications are effective treatments for attention-deficit/hyperactivity disorder, but concerns remain about their effects on growth.


METHODS
We provide a quantitative analysis of longitudinal studies about deficits in expected growth among children with attention-deficit/hyperactivity disorder treated with stimulant medication. Study selection criteria were use of DSM criteria or clear operational definitions for hyperactivity or minimal brain dysfunction; outcome measures including raw, standardized, or percentile measurement of change in height and/or weight; first assessment of effects on growth occurred during childhood; and follow-up for at least 1 year. For issues not suitable for quantitative analyses, we provide a systematic, qualitative review.


RESULTS
The quantitative analyses showed that treatment with stimulant medication led to statistically significant delays in height and weight. This review found statistically significant evidence of attenuation of these deficits over time. The qualitative review suggested that growth deficits may be dose dependent, deficits may not differ between methylphenidate and amphetamine, treatment cessation may lead to normalization of growth, and further research should assess the idea that attention-deficit/hyperactivity disorder itself may be associated with dysregulated growth.


CONCLUSIONS
Treatment with stimulants in childhood modestly reduced expected height and weight. Although these effects attenuate over time and some data suggest that ultimate adult growth parameters are not affected, more work is needed to clarify the effects of continuous treatment from childhood to adulthood. Although physicians should monitor height, deficits in height and weight do not appear to be a clinical concern for most children treated with stimulants.
Faraone
Stephen V
SV
Departments of Psychiatry, SUNY Upstate Medical University, Syracuse, NY 13210, USA. faraones@upstate.edu
Biederman
Joseph
J
Morley
Christopher P
CP
Spencer
Thomas J
TJ
D000661:Amphetamine / Q000009:adverse effects / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001827:Body Height / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects*; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use
D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000661:Amphetamine