Objective: To investigate if there are any disease-related or methylphenidate-induced aberrations in growth parameters, growth hormone insulin-like growth factor (IGF)-I, IGFBP-3 axis and the thyroid function tests in children with attention deficit hyperactivity disorder (ADHD). Methods: Newly diagnosed and untreated prepubertal children with ADHD were longitudinally followed before and approximately every 4 months after methylphenidate treatment for up to 16 months. Height SDS, weight SDS, BMI SDS, serum GH, IGF-I, IGFBP-3, T4, free T4, T3, and TSH were measured at each visit. Results: All of the examined parameters were within normal limits for age before treatment. Methylphenidate treatment did not significantly affect SDS of height, weight, BMI, IGF-I and IGFBP-3 in the long run. Serum T4 and free T4 levels showed modest reductions within normal limits in a time-dependent manner. Conclusions: Prepubertal children with ADHD had normal height, weight, BMI, serum IGF-I and IGFBP-3 and thyroid functions. Methylphenidate treatment had no sustained effects on growth parameters, IGF-I and IGFBP-3 during the follow-up period of this study. However, it caused a mild decrease in total and free T4 which may warrant further monitoring.

Keywords:
Attention deficit hyperactivity disorder, Growth in hyperactive children, IGF-I, IGFBP-3, Thyroid, Methylphenidate
1.
Castellanos F, Giedd J, Marsh W, Hamburger SD, Vaituzis AC, Dickstein DP, Sarfatti SE, Vauss YC, Snell JW, Lange N, Kaysen D, Krain AL, Ritchie GF, Rajapakse JC, Rapoport JL et al: Quantitative brain magnetic resonance imaging in attention deficit hyperactivity disorder. Arch Gen Psychiatry 1996;53:607–616.
2.
Hauser P, Zametkin AJ, Martinez Hauser P, Zametkin AJ, Martinez P, Vitiello B, Matochik JA, Mixson AJ, Weintraub BD et al: Attention deficit hyperactivity disorder in people with generalized resistance to thyroid hormone. N Engl J Med 1993;328:997–1001.
3.
Refetoff S, Weiss RE, Usala SJ: The syndromes of resistance to thyroid hormone. Endocr Rev 1993;14:348–399.
4.
Weiss RE, Stein MA, Trommer B, Refetoff S: Attention deficit hyperactivity disorder and thyroid function. J Pediatr 1993;123:539–545.
5.
Spencer T, Biederman J, Wilens T, Guite J, Harding M: ADHD and thyroid abnormalities: A research note. J Child Psychol Psychiatry 1995;36:879–885.
6.
Valentine J, Rossi E, O’Leary P, Parry TS, Kurinczuk JJ, Sly P: Thyroid function in a population of children with attention deficit hyperactivity disorder. J Paediatr Child Health 1997;33:117–120.
7.
Toren P, Karasik A, Eldar S, Wolmer L, Shimon I, Weitz R, Inbar D, Koren S, Pariente C, Reiss A, Weizman R, Laor N: Thyroid function in attention deficit and hyperactivity disorder. J Psychiatr Res 1997;31:359–363.
8.
Stein MA, Weiss RE: Thyroid function tests and neurocognitive functioning in children referred for attention deficit/hyperactivity disorder. Psychoneuroendocrinology 2003;28:304–316.
9.
Safer DJ, Allen RP: Factors influencing the suppressant effects of two stimulant drugs on the growth of hyperactive children. J Pediatr 1973;51:660–667.
10.
Satterfield JH, Cantwell DP, Schell A, Blaschke T: Growth of hyperactive children treated with methylphenidate. Arch Gen Psychiatry 1979;36:212–217.
11.
Mattes JA, Gitelman R: Growth of hyperactive children on maintenance regimen of methylphenidate. Arch Gen Psychiatry 1983;40:317–321.
12.
Safer DJ, Allen RP, Barr E: Depression of growth in hyperactive children on stimulant drugs. N Engl J Med 1972;287:217–220.
13.
Loney J, Whaley KMA, Ponto LB, Adney K: Predictors of adolescent height and weight in hyperkinetic boys treated with methylphenidate. Psychopharmacol Bull 1981;17:132–134.
14.
Weiss G, Kruger E, Danielson U, Elman M: Effect of long-term treatment of hyperactive children with methylphenidate. Can Med Assoc J 1975;112:159.
15.
Gittelman R, Landa B, Mattes J, Klein D: Methylphenidate and growth in hyperactive children: A controlled withdrawal study. Arch Gen Psychiatry 1988;45:1127–1130.
16.
Eisenberg L: The hyperkinetic child and stimulant drugs. N Engl J Med 1972;287:249–250.
17.
Quinn PO, Rapoport JL: One-year follow-up of hyperactive boys treated with imipramine or methylphenidate. Am J Psychiatry 1975;132:241–245.
18.
Millichap JG, Millichap M: Growth of hyperactive children N Engl J Med 1975;292:1300.
19.
Gross M: Growth of hyperkinetic children taking methylphenidate, dextroamphetamine, or imipramine/desipramine. J Pediatr 1976;58:423–431.
20.
McNutt BA, Boileau RA, Cohen MN: The effects of long-term stimulant medication on the growth and body composition of hyperactive children. Psychopharmacology 1977;13:36–38.
21.
Kalachnik JE Sprague RL, Sleator EK, Cohen MN, Ullmann RK: Effect of methylphenidate, hydrochloride on stature of hyperactive children. Dev Med Child Neurol 1982;70:987–992.
22.
Vincent J, Varley C, Leger P: Effects of methylphenidate on early adolescent growth. Am J Psychiatry 1990;147:501–502.
23.
Biederman J, Faraone SV, Monuteaux MC, Plunkett EA, Gifford J, Spencer T: Growth deficits and attention-deficit/hyperactivity disorder revisited: Impact of gender, development, and treatment. Pediatrics 2003;111:1010–1016.
24.
Sund AM, Zeiner P: Does extended medication with amphetamine or methylphenidate reduce growth in hyperactive children? Nord J Psychiatry 2002;56:53–57.
25.
Lisska MC, Rivkees SA: Daily methylphenidate use slows the growth of children: A community-based study. J Pediatr Endocrinol Metab 2003;16:711–718.
26.
Spencer T, Biederman J, Harding M, Odonnell D, Faraone S, Wilens T: Growth deficits in ADHD children revisited: Evidence for disorder associated growth delays? J Am Acad Child Adolesc Psychiatry 1996;35:1460–1469.
27.
Neyzi O, Binyıldız P, Alp H: Growth standards for Turkish children: Heights and weights. Courier 1979;29:553–558.
28.
Cole TJ, Bellizzi MC, Flegyl KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide. BMJ 2000;320:1–6.
29.
Bereket A, Turan S, Haklar G: Serum IGF-I and IGFBP-3 levels during childhood and adolescence: Establishment of normative values with emphasis on puberty and socioeconomical status. Horm Res 2003;60(suppl 2):P3–240.
30.
Poulton A, Cowell CT: Slowing of growth in height and weight on stimulants: A characteristic pattern. J Paediatr Child Health 2003;39:180.
31.
Spencer T, Biederman J, Wilens T: Growth deficits in children with attention deficit hyperactivity disorder. Pediatrics 1998;102:501–506.
32.
Schultz F, Hayford J, Wolraich M, Hintz R, Thompson R: Methylphenidate treatment of hyperactive children: Effects on the hypothalamic-pituitary-somatomedin axis. J Pediatr 1982;70:987–992.
33.
Kilgore BS, Dickinson MA, Burnett CR, Lee J, Schedewie HK, Elders MJ: Alterations in cartilage metabolism by neurostimulant drugs. J Pediatr 1979;94:542–545.
34.
Toren P, Silbergeld A, Eldar S, Laor N, Wolmer L, Koren S, Weitz R, Inbar D, Reiss A, Eshet R, Weizman R: Lack of effect of methylphenidate on serum growth hormone (GH), GH-binding protein, and insulin-like growth factor I. Clin Neuropharmacol 1997;20:264–269.
© 2005 S. Karger AG, Basel
2005
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