Editorial: Time for a New Conversation on Stimulant Use

Area of Science:

• Child and Adolescent Psychiatry
• Pharmacology
• Growth and Development

Background:

• Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition often managed with psychostimulants.
• Previous studies, like the MTA, indicated potential height suppression with long-term stimulant use in children.
• Guidelines recommend ongoing evaluation of stimulant medication for ADHD due to its chronic nature.

Discussion:

• This study analyzed growth trajectories in children with ADHD on stimulant medication versus a normative group.
• Findings reveal distinct growth patterns, especially during puberty, with greater stimulant dosage correlating with height reduction.
• A novel finding is the association between higher lifetime stimulant doses and increased weight and BMI gain.

Key Insights:

• Consistent stimulant users in young adulthood were significantly shorter and heavier than negligible users.
• Estimated height decrement was 4.06 cm and weight gain was 4.50 kg for consistent users.
• These findings highlight potential adverse effects beyond height suppression, including weight gain and BMI increase.

Outlook:

• Replication of these findings is crucial, ideally funded by independent sources.
• Clinical discussions should now include both height suppression and weight gain risks associated with stimulant therapy.
• Further research should focus on non-medication interventions and treatment goals encompassing overall functioning and quality of life.