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The Informed Parent

Stimulants and Growth

by John H. Samson, M.D., F.A.A.P.
Published on Nov. 03, 2008
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“Stimulates and growth” is a much discussed topic, both in the spoken and written word. It has been covered extensively in the lay press and medical literature. Talk radio has spent hours broadcasting on this subject. Much of this verbiage is neither substantiated nor carefully researched. Therefore it is of little value. Too often personal opinions are felt to be validated because they appear in the media. Probably the greatest source of opinions given as fact is the internet.

Evaluate the author, the source, when assessing the credibility of a given report or article.

I realize you are reading this on the internet and, please, use the same standards to evaluate this article.

On The Informed Parent we take our writing very seriously. We base our conclusions on peer reviewed articles and years of experience.

An excellent article appeared in the Journal of American Academy of Child and Adolescent Psychiatry in September 2008 which prompted me to cover this topic now.

Effect of Stimulants on Height and Weight: A Review of the Literature was written by Stephen V. Faraone, Ph.D., Joseph Biederman, M.D., Christopher R. Morley, M.A., and Thomas J. Spencer, M.D. Sixty-five papers were reviewed which covered this topic in an attempt to statistically analyze the question and arrive at an answer.

Because of the heterogeneity of the various studies it was difficult if not impossible to correlate all the data into one giant study. Yet some very important concepts rose to the surface:

  1. The effectiveness of methylphenidate (MPH) and amphetamine (AMP) to control the signs and symptoms of attention-deficit/hyperactivity disorder (ADHD) was significant.
  2. The studies that showed growth attenuation in long-term follow-up suggest that the growth deficits normalize over time so that final height is not affected.
  3. Some articles suggested that growth deficits in children with ADHD may be early temporary manifestations of ADHD itself.
  4. A. Bereket, S. Turan, M.G. Karaman, G. Haklar, F. Ozbay, and M.Y. Yazgan in Horm. Res. 2005; 63: 159-164 reported that MPH treatment causes a mild transient decrease in metabolites of human growth hormone in the first four months of therapy than normalized with continued treatment.
  5. Patients treated with MPH or AMP may experience a decrease in appetite. If no compensation takes place malnutrition may be created which may effect height velocity gain. The critical point here is compensation. That is, maneuvers to assure adequate caloric intake must be done. This then removes the issue as a causative factor to height gain lack.

Discuss such measures with your child’s doctor. In my own practice this is not hard to accomplish if the parents are flexible and allow the child to eat dinner later in the evening.

Next month we will discuss drug holidays--good or bad. The authors of this article draw a conclusion to the question “Effect of Stimulants on Height and Weight”. Stay tuned.




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