Related Experiment Videos
Methylphenidate-related growth impairment
Kristian Holtkamp1, Birgitta Peters-Wallraf, Stefan Wüller
1Department of Child and Adolescent Psychiatry and Psychotherapy, Technical University, Aachen, Germany. Kristian.Holtkamp@kjp.rwth-aachen.de
Insights
Stimulant medication for attention deficit hyperactivity disorder (ADHD) may cause significant growth problems in some children. Careful monitoring of growth velocity is crucial, even without gastrointestinal side effects.
Area of Science:
- Pediatric Endocrinology
- Neurodevelopmental Disorders
- Pharmacology
Background:
- Growth deficits in children with attention deficit hyperactivity disorder (ADHD) treated with methylphenidate (MPH) are debated.
- While often considered slight, severe growth deficits linked to MPH are rarely reported, typically with gastrointestinal issues.
Observation:
- A 10-year-old boy with ADHD and asthma on corticosteroids experienced near-complete growth arrest during MPH treatment.
- Growth hormone (GH) stimulation tests and related growth factors suggested MPH interfered with GH secretion.
Findings:
- Methylphenidate (MPH) may significantly impair growth in susceptible children with ADHD.
- Growth velocity determination proved a sensitive indicator of MPH-induced growth impairment.
Implications:
- Children with ADHD treated with MPH require careful growth monitoring, irrespective of gastrointestinal symptoms.
- This case highlights a potential risk of severe growth decrement associated with MPH therapy in specific pediatric populations.
Abstract:
Growth deficit associated with stimulants in children who have attention deficit hyperactivity disorder (ADHD) has long been the subject of scientific discussion. More recent studies describe the effects on the final height of children with ADHD who are treated with methylphenidate (MPH) as only slight. There are only a handful of reports of severe growth deficits attributed to MPH that are associated with gastrointestinal side effects. We describe a 10-year-old boy with ADHD and chronic asthma who underwent corticosteroid therapy and developed an almost complete growth arrest during MPH treatment. Growth hormone (GH) stimulation tests and measurement of GH-dependent growth factors point to the influence of MPH on GH secretion with subsequent impaired growth. One may conclude that some children are at risk of serious growth decrement when treated with MPH. The growth of children should thus be monitored carefully, even if there are no alarming gastrointestinal side effects from MPH. We found that the determination of growth velocity was a sensitive marker for the evaluation of growth impairment in our patient.