Journal of the American Academy of Child & Adolescent Psychiatry
Volume 47, Issue 9 , Pages 994-1009, September 2008

Effect of Stimulants on Height and Weight: A Review of the Literature

Dr. Faraone is with the Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University; Drs. Biederman and Spencer are with the Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care; and Dr. Morley is with the Department of Family Medicine, SUNY Upstate Medical University

Accepted 1 April 2008.

Disclosure: Dr. Faraone receives research support and honoraria from, is on the speakers' bureaus of, and has had an advisory or consulting relationship with McNeil Pediatrics, Pfeizer, and Shire Laboratories; he also has had an advisory or consulting relationship with Novartis and Eli Lilly. Dr. Spencer has received research support from, is a speaker for, or is on the advisory boards of Shire Laboratories, Eli Lilly, GlaxoSmithKline, McNeil Pharmaceutical, Novartis Pharmaceuticals, New River Pharmaceuticals, Pfizer, Cephalon, and the National Institute of Mental Health (NIMH). Dr. Biederman has received research support from, is a speaker for, or is on the advisory boards of Shire, Eli Lilly, Pfizer, McNeil, Abbott, Bristol-Myers Squibb, New River Pharmaceuticals, Cephalon, UCB Pharma, Janssen, Neurosearch, Stanley Medical Institute, Novartis, Lilly Foundation, Prechter Foundation, AstraZeneca, Forest Laboratories, GlaxoSmithKline, NIMH, National Institute of Child Health and Development, and the National Institute of Drug Abuse. Mr. Morley reports no conflicts of interest.

Abstract 

Objective

Stimulant medications are effective treatments for attention-deficit/hyperactivity disorder, but concerns remain about their effects on growth.

Method

We provide a quantitative analysis of longitudinal studies about deficits in expected growth among children with attention-deficit/hyperactivity disorder treated with stimulant medication. Study selection criteria were use of DSM criteria or clear operational definitions for hyperactivity or minimal brain dysfunction; outcome measures including raw, standardized, or percentile measurement of change in height and/or weight; first assessment of effects on growth occurred during childhood; and follow-up for at least 1 year. For issues not suitable for quantitative analyses, we provide a systematic, qualitative review.

Results

The quantitative analyses showed that treatment with stimulant medication led to statistically significant delays in height and weight. This review found statistically significant evidence of attenuation of these deficits over time. The qualitative review suggested that growth deficits may be dose dependent, deficits may not differ between methylphenidate and amphetamine, treatment cessation may lead to normalization of growth, and further research should assess the idea that attention-deficit/hyperactivity disorder itself may be associated with dysregulated growth.

Conclusions

Treatment with stimulants in childhood modestly reduced expected height and weight. Although these effects attenuate over time and some data suggest that ultimate adult growth parameters are not affected, more work is needed to clarify the effects of continuous treatment from childhood to adulthood. Although physicians should monitor height, deficits in height and weight do not appear to be a clinical concern for most children treated with stimulants. J. Am. Acad. Child Adolesc. Psychiatry, 2008; 47(9):000–000.

Key Words:  attention-deficit/hyperactivity disorder , growth , stimulants , methylphenidate , amphetamine

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 This article was reviewed under and accepted by Ad Hoc Editor Kenneth Towbin, M.D.Article Plus (online-only) materials for this article appear on the Journal's Web site: www.jaacap.com.This article is the subject of an editorial by Dr. Kenneth Towbin in this issue.

PII: S0890-8567(08)60076-3

doi:10.1097/CHI.ObO13e31817eOea7

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 47, Issue 9 , Pages 994-1009, September 2008

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