title: Dietary intake, growth and development of children with ADHD in a randomized clinical trial of Ritalin and Melatonin co-administration: Through circadian cycle modification or appetite enhancement?
abstract: OBJECTIVE
  It is postulated that ritalin may adversely affect sleep, appetite, weight and growth of some children with ADHD. Therefore, we aimed to evaluate melatonin supplementation effects on dietary intake, growth and development of children with ADHD treated with ritalin through circadian cycle modification and appetite mechanisms.
  
  
  METHODS
  After obtaining consent from parents, 50 children aged 7-12 with combined form of AD/HD were randomly divided into two groups based on gender blocks: one received melatonin (3 or 6 mg based on weight) combined with ritalin (1mg/kg) and the other took placebo combined with ritalin (1mg/kg) in a double blind randomized clinical trial. Three-day food record, and standard weight and height of children were evaluated prior to the treatment and 8 weeks after the treatment. Children's appetite and sleep were evaluated in weeks 0, 2, 4 and 8. Hypotheses were then analyzed using SPSS17.
  
  
  RESULTS
  Paired sample t-test showed significant changes in sleep latency (23.15±15.25 vs. 17.96±11.66; p=0.047) and total sleep disturbance score (48.84±13.42 vs. 41.30±9.67; p=0.000) before and after melatonin administration, respectively. However, appetite and food intake did not change significantly during the study. Sleep duration and appetite were significantly correlated in melatonin group (Pearson r=0.971, p=0.029). Mean height (138.28±16.24 vs. 141.35±16.78; P=0.000) and weight (36.73±17.82 vs. 38.97±17.93; P=0.005) were significantly increased in melatonin treated children before and after the trial.
  
  
  CONCLUSIONS
  Administration of melatonin along with ritalin improves height and weight growth of children. These effects may be attributed to circadian cycle modification, increasing sleep duration and the consequent more growth hormone release during sleep.
authors.affiliation: Department of Nutrition & Biochemistry, School of Public Health, Tehran University of Medical Sciences.
authors.forename: Seyed-Ali
authors.initials: SA
authors.lastname: Mostafavi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Mohammadi
authors.forename: Payam
authors.initials: P
authors.lastname: Hosseinzadeh
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Eshraghian
authors.forename: Shahin
authors.initials: S
authors.lastname: Akhondzadeh
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Hosseinzadeh-Attar
authors.forename: Elham
authors.initials: E
authors.lastname: Ranjbar
authors.forename: Seyed Mohammad-Ali
authors.initials: SM
authors.lastname: Kooshesh
authors.forename: Seyed-Ali
authors.initials: SA
authors.lastname: Keshavarz
keywords: Attention Deficit Disorder with Hyperactivity; Diet; Growth and Development; Melatonin; Ritalin