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Study links ADHD drugs to puberty problems in boys

Adolescent boys who take stimulant medication to treat attention deficit hyperactivity disorder (ADHD) for more than three…

Ritalin can depress appetite, which may slow growth.

Adolescent boys who take stimulant medication to treat attention deficit hyperactivity disorder (ADHD) for more than three years are likely to be slimmer and shorter than their peers, a new study has found.

ADHD, characterised by a difficulty in staying focused and paying attention, is sometimes treated with drugs such as methylphenidate (Ritalin) or dexamphetamine, as well as behavioural programs.

The study, published today in the Medical Journal of Australia, examined data on 65 boys aged between 12 and 16 years who had ADHD and had been on stimulant medication for more than three years.

Boys aged between 12 and 14 years who took stimulant drugs for ADHD were lighter and slimmer than boys of the same age without ADHD.

Boys aged between 14 and 16 years with ADHD had lower weight but were also significantly shorter than the control group, the study found.

The researchers also found that taking ADHD stimulant medication could affect the rate that boys progress through puberty.

“For the younger children who were between ages 12 and 14, there wasn’t any discernible difference in the stage of puberty between them and the control group. But in the older boys, the 14 to 16-year-olds, the ones on ADHD medication were behind in their puberty,” said lead author, Dr Alison Poulton, clinical senior lecturer at Sydney Medical School Nepean, at the University of Sydney.

“That suggests that in early puberty the ADHD boys are entering puberty at the same age but it looks as though they may be progressing more slowly.”

Dr Poulton said that children who take ADHD stimulant medication can lose their appetite, which can slow down their growth.

“I think the important thing is no one should be treated unless they have got a significant problem. If the problem is bad enough, you consider all available treatments, including behavioural treatment and if necessary, medication,” she said.

“You weigh up the pros and cons of treating and of not treating. The effect on weight and growth in height needs to be taken into consideration.”

Dr Poulton said ceasing medication could allow boys to ‘catch up’ on their growth within a year to 18 months, but that it was important to remember that height and age of puberty varies greatly within families and among peers anyway.

Dr Brenton Prosser, a senior lecturer at the Australian National University’s School of Sociology and a researcher of the sociology of ADHD said that the notion that medication stunts growth is not new.

“But I agree with the authors, this is the first study that I am aware of that seeks to measure it, definitely in Australia,” said Dr Prosser, who was not involved in the study.

“The common wisdom is that medication inhibits appetite which restricts growth in height and weight over the longer term. Their finding that it delays puberty is a bit more bold and less convincing. How does one define, standardise and measure something that is so unique to the individual and subjective?”

“My position on all such studies is that individual development and medication are important matters to understand, but what turns these physical and behavioural characteristics into problems are the reactions of those around - that is, society.”

“We need to understand both sides of the coin, because only looking at one side produces a ‘medication is good or bad’ debate, which is ultimately unhelpful,” he said.

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11 Comments sorted by

  1. Richard Windsor

    logged in via Facebook

    Again, Academic Excellence and Journalistic Flair laid waste in the stroke of a pen.
    True, there are minor, transient changes in the growth trajectories of young people treated for ADHD with stimulant medications. This is somewhat of a red herring as the real issue is the developmental delays associated with untreated ADHD. This is something that can be well understood by competent readers. A digestible summary is found here

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    1. Sunanda Creagh

      Editor at The Conversation

      In reply to Richard Windsor

      Hi Richard. Just letting you know that the article and the headline were approved by the author of the original study, so I am confident we have communicated their findings correctly. Thanks.

  2. Jack Arnold


    I am unable to accept that parents are directed by doctors to feed Speed to their kids for breakfast!!!

    In contrast, one teacher colleague controlled ADD students by physically exhausting them during first period every day.

    ADD is an asset to the person who generally has enormous hyperfocus, and an independent analytical mind. Try being a professional individual sport athlete without these skills.

    Then, in my generation we needed ADD to complete the academic workload then required of all tertiary students by our generally exceptional professors. (This workload & teacher quality has since declined markedly).

    ADD is not a problem, the problem is Big Pharma creating the biggest unnecessary market since anti-perspirants.

  3. Chris Borthwick


    The problem I see is that the comparison between boys with ADHD on medication and boys with no ADHD and no medication ignores the possibility that ADHD has physical correlates. You actually need a control group made up of boys with ADHD not on medication.

    1. Richard Windsor

      logged in via Facebook

      In reply to Chris Borthwick

      Chris, does this go someway to answering your question?

      Objective: A small literature suggests that ADHD may be associated with dysregulated growth, but this prior work primarily used clinically referred samples, so it faces difficulties of interpretation. The objective of this study is to sample the general French population for ADHD and evaluate if ADHD is associated with dysregulated growth. Methods: Starting with 18 million telephone…

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  4. Chris Borthwick


    And, of course,

    Marge: Well, I'm not going to give my baby any more dangerous drugs.
    From now on, it's nothing but fresh air, lots of hugs, and
    good old-fashioned Ritalin.
    [hands Bart some Ritalin]
    Bart: You said a mouthful. [takes pills]
    [singing to the tune of "Popeye, the Sailor Man"]
    When I can't stop my fiddlin'
    I just takes me Ritalin
    I'm poppin' and sailin', man!
    [two toots of steam come out his ears]

    1. Jack Arnold


      In reply to Chris Borthwick

      Hi Chris ... what part of the above Windsor post did you NOT understand?? Perhaps I could translate it into standard English for you.

      ADHD medication causes changes in the growth pattern of recipient children depending upon the age of the individual child. There may be growth dysregulation evident in kids allegedly having ADHD.

      Regardless, it is still abhorrent that parents are encouraged by doctors to feed Speed to their kids for breakfast.

    2. Richard Windsor

      logged in via Facebook

      In reply to Jack Arnold

      Dear Jack
      I'll chide you gently as you are a lamb that has lost his way.Chris Borthwick has not read my reply to his question so your querulous response was pre-emptive. On that foot I feel that you haven't read it either or my original piece and need to do this before you mire yourself any further.
      I originally took Creagh to task for entering into a tabloid journalistic frenzy and competely missing the plot.
      You need to read Tony Eastley's interview with Alison Poulton here

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    3. Richard Windsor

      logged in via Facebook

      In reply to Richard Windsor

      I forgot this
      only 3 pp
      'Consequently,BMI might be an indirect indicator for the subtype of
      attention-deficit/hyperactivity disorder and/or the likely compliance with medication."(Alison Poulton)
      In Reply.—
      Drs Poulton et al suggest an alternative explanation for
      the findings of our recent study.1 We acknowledge that
      we were not able to explore weight status in relation
      to attention-deficit disorder (ADD)/attention-deficit/hyperactivity
      disorder (ADHD) subtype; the National Survey
      of Children’s Health did not ask respondents about
      ADD/ADHD subtype. However, even if lack of medication
      use is a marker for inattentive ADD/ADHD, it would
      still be prudent to monitor these children for weight gain
      and overweight. We agree that future research should
      consider ADD/ADHD subtype to further our understanding
      of the relationship between ADD/ADHD and
      weight status among children and adolescents.