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Growth of hyperkinetic children taking methylphenidate, dextroamphetamine, or imipramine/desipramine
Insights
Long-term use of stimulant medications like methylphenidate and dextroamphetamine, along with imipramine/desipramine, does not stunt growth in children with hyperkinetic syndrome. Initial growth slowing is later compensated, showing no adverse effects on height or weight percentiles.
Area of Science:
- Pediatric Pharmacology
- Child Psychology
- Neurodevelopmental Disorders
Background:
- Hyperkinetic syndrome and minimal brain dysfunction are common childhood conditions.
- Stimulant medications are frequently prescribed for these disorders.
- Concerns exist regarding the long-term effects of these medications on child growth.
Purpose of the Study:
- To investigate the long-term effects of methylphenidate, dextroamphetamine, imipramine, and desipramine on the physical growth of children.
- To determine if medication dosage or duration correlates with changes in growth percentiles.
Main Methods:
- Longitudinal study of 100 children diagnosed with hyperkinetic syndrome or minimal brain dysfunction.
- Medication included methylphenidate (n=60), dextroamphetamine (n=24), and imipramine/desipramine (n=16).
- Height and weight measurements were taken before, during, and after treatment (average 5 years treatment, 6 years follow-up), converted to percentiles using Iowa City norms.
Main Results:
- Initial decrease in expected weight, but not height, was observed.
- After several years, statistically significant increases in both weight and height percentiles were noted compared to norms.
- No significant correlation found between medication dosage and changes in growth percentiles.
Conclusions:
- Long-term use of methylphenidate, dextroamphetamine, imipramine, or desipramine does not cause stunting of growth in children.
- Any initial growth deceleration is compensated for over time, irrespective of continued medication use.
- These findings alleviate concerns about growth inhibition associated with these common ADHD medications.
Abstract:
One hundred children with the hyperkinetic syndrome or minimal brain dysfunction syndrome were treated with medication: 60 with methylphenidate (Ritalin), 24 with dextroamphetamine (Dexedrine), and 16 with either imipramine or desipramine. The duration of treatment was for a minimum of two years, and averaged five years, with an average follow-up of six years from the onset of treatment. Their weight and height had been measured prior to treatment, and these and subsequent measurements were converted to percentiles, using the tables of norms of the Iowa City study. Initially there was a diminution in expected weight, but not height, but after a few years the growth in weight and height was found to be greater than predicted from the norms to a statistically significant degree. Gains in weight and height were greater for those whose medication had been stopped prior to the final measurements than for those still taking medication; but these differences did not reach statistical significance. No correlations were found between dosage level and changes in weight and height percentiles. It is concluded that there is no stunting of growth from the long-term use of methylphenidate, dextroamphetamine, or imipramine/desipramine in children. Any slowing of growth when treatment is first started is compensated for later on, both while the patient is still taking the medication, and after discontinuing it.