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Growth of hyperactive children on maintenance regimen of methylphenidate
Insights
Methylphenidate hydrochloride, a stimulant for hyperactive children, may decrease height and weight percentiles over time, particularly with higher dosages. Clinicians should monitor growth and consider dose adjustments if suppression occurs.
Area of Science:
- Pediatric Endocrinology
- Neurodevelopmental Disorders
- Pharmacology
Background:
- Hyperactive children often receive stimulant medications like methylphenidate hydrochloride.
- Growth monitoring is crucial for children undergoing long-term treatment.
- Previous studies have shown mixed results regarding stimulant effects on growth.
Purpose of the Study:
- To assess the long-term effects of methylphenidate hydrochloride on height and weight in hyperactive children.
- To determine the relationship between methylphenidate dosage and growth suppression.
- To investigate the impact of adjunctive thioridazine hydrochloride on growth.
Main Methods:
- Compared growth data of 86 hyperactive children on methylphenidate with population norms.
- Analyzed height and weight percentiles over one to four years of treatment.
- Correlated dosage and initial growth parameters with growth decrements.
Main Results:
- Significant decreases in height percentile observed after 2, 3, and 4 years of methylphenidate treatment.
- Weight percentile loss began after the first year of treatment.
- Higher dosages and greater initial height/weight were associated with more pronounced growth suppression.
Conclusions:
- Methylphenidate hydrochloride can lead to modest growth suppression in hyperactive children.
- Dosage is a significant factor influencing the degree of growth reduction.
- Regular growth monitoring and potential dosage adjustments are recommended for children on stimulant therapy.
Abstract:
The growth in height and weight of 86 hyperactive children receiving methylphenidate hydrochloride (average, 40 mg/day for up to four years) was compared with general population norms on recently updated growth charts. A significant decrease in height percentile was apparent after 2, 3, and 4 years of treatment but not after one year. A significant loss in weight percentile occurred onward from the first year of treatment. Dosage was significantly associated with the decrease in height and weight percentile. Greater initial height and weight were associated with greater growth decrements. The use of adjunctive thioridazine hydrochloride (mean, 87 mg/day) did not influence the growth of children receiving methylphenidate. Although the magnitude of the growth suppressant effect in groups was small (dosage accounted for only 2% of the variance in final height), the results suggest that clinicians should monitor the growth of hyperactive children receiving stimulants and consider dosage reduction in individual cases should evidence of growth suppression occur.