Journal of the American Academy of Child & Adolescent Psychiatry
Volume 47, Issue 9 , Pages 977-980 , September 2008

Paying Attention to Stimulants: Height, Weight, and Cardiovascular Monitoring in Clinical Practice

  • Kenneth Towbin, M.D.

      Affiliations

    • Corresponding Author InformationCorrespondence to Dr. Kenneth Towbin, Emotion & Development Branch, Mood & Anxiety Disorder Program, NIMH/NIH, CRC Room 1–3633, 9000 Rockville Pike, Bethesda, MD 20892–1281

Received 25 April 2008

References 

  1. Faraone SV, Biederman J, Morley CP, Spencer TJ. Effect of stimulants on height and weight: a review of the literature. J Am Acad Child Adolesc Psychiatry. 2008;47;[E-pub ahead of print; DOI:10.1097/CHI0b013e31817e0ea7].
  2. Vetter VL, Elia J, Erickson C, et al. Cardiovascular monitoring of children and adolescents with heart disease receiving stimulant drugs. A scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing. Circulation. 2008;[E-pub ahead of print April 21, 2008]
  3. Mattes JA, Gittelman R. Growth of hyperactive children on maintenance regimen of methylphenidate. Arch Gen Psychiatry. 1983;40:317–321
  4. Klein RG, Mannuzza S. Hyperactive boys almost grown up. III. Methylphenidate effects on ultimate height. Arch Gen Psychiatry. 1988;45:1131–1134
  5. Greenhill LL, Puig-Antich J, Novacenko H, et al. Prolactin, growth hormone and growth responses in boys with attention deficit disorder and hyperactivity treated with methylphenidate. J Am Acad Child Psychiatry. 1984;23:58–67
  6. MTA Cooperative Group . National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: changes in effectiveness and growth after the end of treatment. Pediatrics. 2004;113:762–769
  7. Kraemer HC, Morgan GA, Leech NL, Gliner JA, Vaske JJ, Harmon RJ. Measures of clinical significance. J Am Acad Child Adolesc Psychiatry. 2003;42:1524–1529
  8. Spencer TJ, Kratochvil CJ, Sangal RB, et al. Effects of atomoxetine on growth in children with attention-deficit/hyperactivity disorder following up to five years of reatment. J Child Adolesc Psychopharmacol. 2007;17:689–700
  9. Weintrob N, Cohen D, Klipper-Aurbach Y, Zadik Z, Dickerman Z. Decreased growth during therapy with selective serotonin reuptake inhibitors. Arch Pediatr Adolesc Med. 2002;156:696–701
  10. Nilsson M, Joliat MJ, Miner CM, Brown EB, Heiligenstein JH. Safety of subchronic treatment with fluoxetine for major depressive disorder in children and adolescents. J Child Adolesc Psychopharmacol. 2004;14:412–417
  11. Gutgesell H, Atkins D, Barst R, et al. Cardiovascular monitoring of children and adolescents receiving psychotropic drugs: a statement for healthcare professionals from the Committee on Congenital Cardiac Defects, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 1999;99:979–982
  12. Maloney MJ, Schwam JS. Clonidine and sudden death. Pediatrics. 1995;96:1176–1177
  13. Blackman JA, Samson-Fang L, Gutgesell H. Clonidine and electrocardiograms. Pediatrics. 1996;98:1223–1224
  14. Maloney MJ, Schwam JS. In reply to Blackman et al. Pediatrics. 1996;98:1224–1225
  15. U.S. Department of Health and Human Services, FDA. Center for Drug Evaluation and Research. Proceedings of the Drug Safety and Risk Management Advisory Committee Meeting February 9, 2006. http://www.fda.gov/ohrms/dockets/ac/06/transcripts/2006–4202tl.pdf. Accessed April 25, 2008.
  16. Rappley MD, Moore JW, Dokken D. ADHD drugs and cardiovascular risk. N Engl J Med. 2006;354:2296–2298
  17. U.S. Department of Health and Human Services, FDA. Proceedings of the Pediatric Advisory Committee Meeting, March 22, 2006. http://www.fda.gov/ohrms/dockets/ac/06/transcripts/2006-4210t_01_Draft%20-%20Transcript%200322fda.htm. Accessed April 25, 2008.
  18. Greenhill LL, Pliszka S, Dulcan MK, et al. Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. J Am Acad Child Adolesc Psychiatry. 2002;41:26S–49S
  19. Wilens TE, Prince JB, Spencer TJ, Biederman J. Stimulants and sudden death: what is a physician to do?. Pediatrics. 2006;118:1215–1219
  20. Maron BJ, Thompson PD, Ackerman MJ, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes. 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation. 2007;115:1643–1655

 EDITOR'S NOTEAfter Dr. Towbin's editorial went to press but before it could appear in the June Publish Ahead of Print feature of the Journal, the American Heart Association issued a clarification of its April 21, 2008 release (available online at http://circ.ahajournals.org/cgi/content/full/CIRCULATIONAHA.107.189473/DC1). The most important point in the clarification is that “…it is reasonable for a physician to consider obtaining an ECG as part of the evaluation of children being considered for stimulant drug therapy, but this should be at the physician's judgment, and it is not mandatory to obtain one.” This revised statement has been endorsed by the American Academy of Child and Adolescent Psychiatry, the American College of Cardiology, Children and Adults with Attention-Deficit/Hyperactivity Disorder, and the National Initiative for Children's Healthcare Quality. Additional updates and relevant information are likely to appear by the time that Dr. Towbin's editorial appears in print in the September issue of the Journal. The topics of medication side effects and monitoring are rapidly moving targets, and we hope the Journal will be a venue for constructive scientific exchanges about them. To that end, we look forward to seeing studies that are designed to address these critical questions and provide reliable data. In the interim, we welcome comments from our readers.

PII: S0890-8567(08)60072-6

doi: 10.1097/CHI.0b013e31817e0eb9

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 47, Issue 9 , Pages 977-980 , September 2008

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