Long term methylphenidate exposure and growth in children and adolescents with ADHD. A systematic review and meta-analysis

Sara Carucci (Lead / Corresponding author), Carla Balia, Antonella Gagliano, Angelico Lampis, Jan K. Buitelaar, Marina Danckaerts, Ralf W. Dittmann, Peter Garas, Chris Hollis, Sarah Inglis, Kerstin Konrad, Hanna Kovshoff, Elizabeth B. Liddle, Suzanne McCarthy, Peter Nagy, Pietro Panei, Roberta Romaniello, Tatiana Usala, Ian C. K. Wong, Tobias BanaschewskiEdmund Sonuga-Barke, David Coghill, Alessandro Zuddas, The ADDUCE Consortium

Research output: Contribution to journalReview articlepeer-review

51 Citations (Scopus)
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Background: Methylphenidate (MPH) is an efficacious treatment for ADHD but concerns have been raised about potential adverse effects of extended treatment on growth.

Objectives: To systematically review the literature, up to December 2018, conducting a meta-analysis of association of long-term (> six months) MPH exposure with height, weight and timing of puberty.

Results: Eighteen studies (ADHD n = 4868) were included in the meta-analysis. MPH was associated with consistent statistically significant pre-post difference for both height (SMD = 0.27, 95% CI 0.16-0.38, p < 0.0001) and weight (SMD = 0.33, 95% CI 0.22-0.44, p < 0.0001) Z scores, with prominent impact on weight during the first 12 months and on height within the first 24-30 months. No significant effects of dose, formulation, age and drug-naïve condition as clinical moderators were found. Data on timing of puberty are currently limited.

Conclusions: Long-term treatment with MPH can result in reduction in height and weight. However, effect sizes are small with possible minimal clinical impact. Long-term prospective studies may help to clarify the underlying biological drivers and specific mediators and moderators.

Original languageEnglish
Pages (from-to)509-525
Number of pages17
JournalNeuroscience and Biobehavioral Reviews
Early online date17 Oct 2020
Publication statusPublished - Jan 2021


  • Attention deficit/hyperactivity disorder (ADHD)
  • methylphenidate
  • stimulants
  • height
  • weight
  • growth
  • puberty

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience


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