Journal
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
Volume 46, Issue 8, Pages 1015-1027Publisher
ELSEVIER SCIENCE INC
DOI: 10.1097/chi.0b013e3180686d7e
Keywords
attention-deficit/hyperactivity disorder; growth; methylphenidate; side effects; long-term outcome
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Funding
- NIMH NIH HHS [N01MH12012, U01 MH50440, N01MH12009, U01 MH50467, U01 MH50477, N01MH 12011, U01 MH50461] Funding Source: Medline
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Objective: To evaluate the hypothesis of stimulant medication effect on physical growth in the follow-up phase of the Multimodal Treatment Study of Children With ADHD. Method: Naturalistic subgroups were established based on patterns of treatment with stimulant medication at baseline, 14-, 24-, and 36-month assessments: not medicated (n = 65), newly medicated (n = 88), consistently medicated (n = 70), and inconsistently medicated (n = 147). Analysis of variance was used to evaluate effects of subgroup and assessment time on measures of relative size (z scores) obtained from growth norms. Results: The subgroup x assessment time interaction was significant for z height (p < .005) and z weight (p < .0001), due primarily to divergence of the newly medicated and the not medicated subgroups. These initially stimulant-naive subgroups had z scores significantly >0 at baseline. The newly medicated subgroup showed decreases in relative size that reached asymptotes by the 36-month assessment, when this group showed average growth of 2.0 cm and 2.7 kg less than the not medicated subgroup, which showed slight increases in relative size. Conclusions: Stimulant-naive school-age children with Combined type attention-deficit/hyperactivity disorder were, as a group, larger than expected from norms before treatment but show stimulant-related decreases in growth rates after initiation of treatment, which appeared to reach asymptotes within 3 years without evidence of growth rebound.
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