It can be challenging for parents to accept a diagnosis of attention deficit hyperactivity (ADHD) for their child. This can raise many questions. Many people are most concerned about whether ADHD medication can stunt growth. For decades, caregivers have asked this question about stimulant medication. Research has shown mixed results over the years. Some studies showed a minimal impact, while others showed no impact. What is the bottom line? ADHD stimulant medications may slightly impact growth, but it is not enough to negatively affect a child's health or happiness. The risk can be minimized with additional monitoring by you and your doctor what you need to be aware of.
What research shows about ADHD medications and growth
The research suggests that the potential growth disruptions are minor.
A long-term study published in the Journal of the American Academy of Child Adolescent Psychiatry tracked kids with ADHD over 16 years. The youngest participant, aged seven at the time of the study's inception in the 1990s, was randomly assigned to one of four categories: medication alone, medication plus behavioral therapy, behavioral therapy alone, or no structured intervention. Five hundred and seventy-nine children were randomly assigned into four categories: medication alone, combined with behavioral therapy, behavior therapy alone, or no structured intervention.
The study revealed two significant findings. The study found two things.
Second, 16 years after the study (with kids in their early 20s), the data showed that those who took stimulants for ADHD without a planned break from doctors were, on average, 1.6 inches shorter than those who did not. This is considered negligible. Children who began taking the medication at a young age were most affected, including those who took them before the study.
A different long-term Pediatrics study followed 1,020 children from childhood into adulthood. It found that neither ADHD nor stimulant treatment was associated with any significant height difference in adulthood.
Another study in Canadian Family Physician showed that any height deficits related to stimulant medication for ADHD could be reversed by a planned break from the medication. The effects of stopping the stimulant medication for a period, such as the summer holidays, were wiped out. It needs to be made clear how long a break from medication should last, as different studies have produced different results. At least one early research found that medication breaks spread over two summers positively impacted the height of children.
It is not clear why stimulants can affect growth (and many other factors, such as the disorder itself, can also influence someone's trajectory of height from childhood into adulthood). However, it could be due to a side effect common with stimulants: appetite suppression. Dr. Greenhill believes that this could be due to a lack of nutrition. The kids are not malnourished. "They are just a little slower in growing."
Stimulants may also lead to sleep disturbances that can affect growth. Children with ADHD, both on and without medication, are known to have a more disruptive sleep onset. This could be an indirect effect. Yamalis Diaz is a clinical assistant professor at NYU Langone Health in New York City.
Weighing Benefits and Risques
Discussing the risks and benefits of any medication with your child's physician before beginning a new regimen would be best. Diaz suggests that you discuss with your doctor the risks and benefits associated with ADHD medication and weigh them against the current risks for the child who is not on medication.
ADHD and the associated behavioral issues can severely impact a child's ability to flourish and live a fulfilling life. Your child may have been sent to the principal's office for getting in trouble or being asked to leave several schools. Maybe they are falling behind in school because they cannot focus. It would help if you considered how much ADHD medication can help your child to stay on track socially and academically. Always follow your doctor's instructions on how to use prescriptions safely.
Ultimately, any growth deficiencies due to ADHD medication are incredibly minor and, realistically, not something you would notice. The benefits of taking medication to control symptoms can be life-changing.
What to discuss with your child's doctor about concerns and options
You can help your child's growth if you decide that ADHD medication is the best choice.
During stimulant treatment, growth should be monitored regularly. Diaz advises that your child's doctor regularly monitor weight gain and loss to ensure no dramatic changes. Diaz says that they monitor the growth of their children to determine if it is too slow.
You can also devise a plan to minimize the effects of ADHD stimulants that may indirectly affect growth. Diaz explains that doctors have developed strategies to counteract adverse effects. For appetite, a strategy would be to add calories before the medication takes effect or provide tasty snacks throughout the day so that the patient will eat them even if they are not hungry. You need to ensure your child's calorie and nutritional intake is adequate.
Talk to your doctor about letting your child first try non-stimulant options. Dr. Greenhill claims that there are ADHD medications that do not have an impact on weight. Some of the medications that have been approved for kids with ADHD are:
Intuniv (guanfacine)
Kapvay (clonidine)
Strattera (atomoxetine)
These medications may be effective for your child as they work differently than stimulants. Diaz says there are many different formulations - pills, liquids, or patches. You can try another if one medication does not work or has unacceptable side effects.
Finding the best medication is often a matter of trial and mistake. There is often a period of adjustment where your child's dosage will be increased or decreased (sometimes quickly) once the doctor determines it can be tolerated. Diaz says that these medications' adjustment, trial, and observation processes are more intense than other classes. However, this process involves trial and observation and can be ordinary and necessary. The process is crucial to getting your child the correct dose and medication.
