Editorial: Height and Stimulant Treatment in Attention-Deficit/Hyperactivity Disorder Youth: Mind the Gap

In this issue of the Journal, the important story of height and weight issues related to stimulant medication in attention-deficit/hyperactivity disorder (ADHD) is yet again addressed, in the largest study to date.1 Controversy related to potential growth decrements in youth with ADHD receiving stimulants has been around for decades. In fact, in a quick PubMed search of the literature, we identified more than 100 studies, 15 reviews, and meta-analyses in this area. In a general score card, about three-fourths of studies seem to support some degree of decrement, but clinical significance has yet to be determined. What is not being debated anymore is the short- and longer-term effectiveness of stimulants for ADHD with reductions in mood disorders, suicide, substance use/disorders, criminality, motor vehicle accidents, injuries, concussions, and academic failure documented in the Swedish and other register studies.2 Many of these improvements are linked with a decrease in major morbidity and even mortality. Hence, we need to put the issue of potential stimulant-related growth velocity changes in the context of the very real adverse outcomes associated with non-treatment of ADHD.