Do ADHD Medications Stunt Children’s Growth?

Worried that negative side effects of your child’s attention deficit hyperactive disorder (ADHD) treatment may mean she’ll be shorter or smaller? Stimulant medications commonly prescribed for patients with ADHD, such as methylphenidate (which is sold by the brand name Ritalin) and amphetamine (which is sold by the brand names Adderall and Dexedrine), have relatively minimal effects on your child’s growth, according to a new article published in the February 2010 issue of Canadian Family Physician Journal. And with monitoring and/or treatment tweaks any loss of height can be reversed.

Although stimulants can carry potential risks for children using them, “current knowledge suggests that the group of stimulant medications have little effect on the rate of height loss, and this effect is likely reversible with withdrawal of treatment,” said Ran D. Goldman, M.D., medical director of the Emergency Medicine department in British Columbia Children’s hospital in Vancouver, Canada, and the author of the article.

In the article he explains that there are three ways stimulant medications can negatively affect how tall your child grows. First, some patients may experience a loss of appetite, which often results in fewer calories consumed. A second theory suggests that increasing dopamine (which is how stimulants work in the treatment of ADHD patients) can cause the suppression of growth hormone secretion and “directly affect height development in children.” Finally, some studies cited in the Canadian Family Physician Journal article have suggested that stimulants may also slow down the development of cartilage tissue, affecting bone growth.

Recent studies have concluded that while there is some apparent effect on growth -- i.e. ADHD children taking stimulants while still growing may experience less growth than their peers -- if a child stops taking the stimulant that has affected their height, they can “catch up” in the growth pace of their peers. This is why some experts recommend patients take “summer breaks” from treatment.

Dr. Goldman suggests that parents “should follow their child’s growth curves and discuss with their health care provider potential ‘breaks’ in stimulant therapy.”

Research related to stunted growth as a side effect of ADHD stimulant medications is limited and Dr. Goldman cautioned that follow-up studies on children who have used stimulants for many years and into their adult lives are “imperative.” “Only after receiving these scientific findings in different groups of children, treated with all types of stimulants and for different treatment length, will we be able to have confirmation to current understanding of the limited height loss.”

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Most Effective ADHD Treatments for Children? Medications and Switching Schools, Parents Say

July 2010: ADHD News

In a recent survey of parents of children with attention deficit hyperactivity disorder (ADD/ADHD), a majority cited drug therapy as the most effective treatment, followed by nearly half who said transferring their child to a more ADHD-friendly school was a helpful intervention.

Tuesday July 20th - 6:30pm

by Mary Kearl

Parents of children with attention deficit hyperactivity disorder (ADD/ADHD), take comfort: If you have turned to medication for treatment -- while longing for an alternative way to manage the condition -- and have found that not every school is equally up to the challenge of addressing your child's learning needs, you're not alone.

A recent Consumer Reports Health Survey of more than 900 parents of ADD/ADHD children, of whom 84 percent treated their child with medication at some point, attempts to give a snapshot of what life is like for you and your children, quantifying some of your daily challenges.

"We wanted to get a sense of what's happening in the real world," said Andrew Schwartz, Ph.D., a licensed clinical psychologist and Consumer Reports survey research associate. Schwartz explained that two limitations of typical ADD/ADHD studies -- the fact that they take place in clinically-controlled environments and are often funded by pharmaceutical companies -- prevent them from being truly representative of daily life. (The Consumer Reports Health Survey was funded solely through Consumers Union, the nonprofit publisher of Consumer Reports.)

When asked to rate the most effective treatments for ADD/ADHD, 67 percent of families surveyed cited ADD/ADHD medication as the "most helpful." Forty-five percent reported that moving their children to a school better equipped to teach children with ADD/ADHD "helped a lot." If they had to do it over again, only 52 percent of parents strongly agreed that they would have their kids take medications and 44 percent said they would prefer to find another way to treat their child.

There are some bright findings regarding medication from the Consumer Reports Health Survey. Most children and teens (60 to 80 percent) who took ADD/ADHD medications usually became less hyperactive and impulsive and their behavior and focus improved. On the whole, medicated children had slightly better outcomes than those who weren't -- particularly with academic success and school behavior.

However, children who tried effective alternative treatments in addition to medication, "did a little bit better than children of parents who didn't find anything else helpful in addition to medication," noted Schwartz. Giving one instruction at a time, hiring a private tutor or learning specialist to work with the child, and providing structure by maintaining daily routines were other non-medical treatments reported as being helpful.

Parents of children on amphetamines (Adderall, Vyvanse) or methylphenidates (Concerta, Daytrana, Ritalin) noted positive changes within a few days of first starting the medication, whereas those on non-stimulant medications, like Strattera, reported experiencing improvements within a few weeks. There were no major differences to be found between amphetamines' effectiveness versus that of methylphenidates, but parents of children on the former were more likely to report "irritability and anger" and "high mood/energy." The survey did not have enough cases of children on non-stimulant medications, like Strattera, to report conclusive findings, but according to the analysis from Consumer Reports, the data indicate that these kinds of medications were less likely to be "very helpful" compared with stimulants.

To learn more about the survey and its findings, visit ConsumerReportsHealth.org. Below, find some additional highlights. • Eighty percent of children covered in the survey attended public school.
• Only 11 percent of parents whose children received an individualized education program (IEP) or other accommodations found them unhelpful.
• Fourteen percent of parents reported that their child had been denied accommodations.
• Three-fourths of parents indicated their child's accommodations were at least "somewhat helpful."
• Compared with pediatricians, child psychiatrists, and psychologists, school professionals (non-psychologists) were more likely to help "a lot" with academic performance. • Psychologists and pediatricians were most likely to help with behavior at home, with the former more so than the latter.
• Psychologists, school professionals, and school psychologists were more likely to help with social-skills building.
• Clinical psychologists were most helpful in boosting children's self-esteem. • The average age of ADD/ADHD diagnosis was seven and a half years old. Of the children who had tried medication, 92 percent started taking medication within one year of being diagnosed.
• Nearly 60 percent of children had seen two or more treatment providers in the last 12 months.
• Fifteen percent of children were not screened before starting medication.
• Among those who reported that their child was no longer taking medication, 35 percent blamed side effects (top complaints included decreased appetite, sleep problems, weight loss, irritability, and upset stomach).
• Of the 934 parents surveyed, 135 never treated their children with medication, with 39 percent wanting to try other options before doing so, and 34 percent reporting that their child's case of ADD/ADHD wasn't severe enough.
• Twenty-nine percent of parents said they wished their child's physician better appreciated their feedback about their child.

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Mary Kearl graduated from New York University with degrees in Journalism and History. She has worked for a variety of online and print publications. Prior to joining New Hope Media, where she serves as the Online Editor of ADDitudemag.com, AdoptiveFamiliesCircle.com, and AdoptiveFamilies.com, she was the Community Editor for AOL Health and Thatsfit.com.

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