Effects of methylphenidate on height, weight and blood biochemistry parameters in prepubertal boys with attention
Ahmet Çevikaslan1, Mesut Parlak2, Hamit Yaşar Ellidağ3
1Child and Adolescent Psychiatry Clinic, Antalya Training and Research Hospital, Turkey.
Insights
Methylphenidate (MPH) treatment in children with ADHD led to a significant decrease in weight z-scores but not height. Monitoring blood variables like glucose and vitamin D is crucial during MPH therapy for growth assessment.
Area of Science:
- Pediatric Endocrinology
- Child and Adolescent Psychiatry
- Pharmacology
Background:
- Long-term effects of stimulant medications on children's growth require further clarification, particularly regarding accompanying metabolic changes.
- Previous studies on stimulant effects on growth in children with attention deficit hyperactivity disorder (ADHD) lack comprehensive metabolic and predictive analyses.
- Understanding the interplay between stimulant treatment, growth deviations, and metabolic alterations is essential for optimizing ADHD management.
Purpose of the Study:
- To investigate the impact of methylphenidate (MPH) on weight, height, and blood biochemistry in prepubertal boys diagnosed with ADHD.
- To identify potential metabolic changes and predictors associated with growth deviations during MPH treatment.
- To establish the necessity of monitoring specific blood parameters alongside growth assessments in pediatric ADHD patients.
Main Methods:
- Open-label, prospective study involving 31 prepubertal boys with ADHD treated with MPH.
- Measurements included height and weight z-scores, and fasting blood samples taken at baseline and 6-month follow-up.
- Statistical analyses included paired-samples t-tests, Wilcoxon signed-rank tests, and Spearman's Rank-Order Correlation (p<0.01).
Main Results:
- A significant decrease in weight z-scores was observed after 6 months of MPH treatment (p=0.000).
- Height z-scores did not show a significant suppression (p=0.14).
- Significant increases in glucose, creatinine, and 25-hydroxyvitamin D (25OH-VitD) levels were noted, while alkaline phosphatase (ALP) decreased (p<0.01).
Conclusions:
- Methylphenidate treatment in children with ADHD can lead to significant weight changes and alterations in specific blood biochemical markers.
- Monitoring blood variables such as glucose, creatinine, 25OH-VitD, and ALP is important for early detection of potential adverse effects during MPH therapy.
- Further research with larger sample sizes is recommended to validate these findings and refine monitoring protocols for pediatric ADHD patients.
Abstract:
Background: Adverse effects of stimulants on growth in children have long been studied, but the results remain to be clarified, because metabolic changes or predictors accompanying the growth deviations were not sufficiently studied. Objective: This open label-prospective study investigated the effects of methylphenidate (MPH) on weight, height, blood biochemistry in children with attention deficit hyperactivity disorder (ADHD). Method: Prepubertal boys treated with MPH in Child and Adolescent Psychiatry Clinic at Antalya Training and Research Hospital in Health Sciences University, Turkey were recruited. Height and weight z-scores and fasting blood samples were taken at baseline and 6th month. Changes were compared by paired-samples t-test or Wilcoxon signed-rank test. Any association between the changes in growth and biochemical values was analyzed by Spearman's Rank-Order Correlation. The statistical significance threshold was p<0.01. Results: 31 boys aged 74 to 104 months were enrolled in the study sample (mean=87.6, Standard Deviation (SD)=9.2). Osmotic release oral system-MPH (18 mg/day) was used in 77.4% (N=24) and immediate release-MPH (5 mg three times a day) in 22.5% (N=7). Average daily drug dose was 0.66 mg/kg (SD=0.12). Baseline weight z-score was 0.63 (SD=1.12), decreased significantly at 6 months (0.24 [SD=1.04]) (Z=-4.44, p=0.000, r=0.5) (median z-score was 0.53 at baseline, -0.11 at 6 months). Baseline height z-score (0.23[SD=0.87]) was not suppressed significantly at 6 months (0.28[SD=0.85])(t(30) = ‒1.50, p=0.14). Glucose (t(30) = -4.33, p=0.000, r=0.6), creatinine (t(30)=-3.28, p=0.003, r=0.5) and 25OH-VitD (N=29, Z=-3.98, p=0.000, r=0.5) increased but alkaline phosphatase (ALP) decreased (t(28)=3.63, p=0.001, r=0.5). The differences in W-SDS and ALP were positively correlated (r=0.47, p=0.009). Conclusions: Our results indicate the importance of monitoring blood variables that may accompany growth changes early in MPH treatment and should be further assessed in larger samples.
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