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

TY - JOUR

T1 - Long term methylphenidate exposure and growth in children and adolescents with ADHD. A systematic review and meta-analysis

AU - Carucci, Sara

AU - Balia, Carla

AU - Gagliano, Antonella

AU - Lampis, Angelico

AU - Buitelaar, Jan K.

AU - Danckaerts, Marina

AU - Dittmann, Ralf W.

AU - Garas, Peter

AU - Hollis, Chris

AU - Inglis, Sarah

AU - Konrad, Kerstin

AU - Kovshoff, Hanna

AU - Liddle, Elizabeth B.

AU - McCarthy, Suzanne

AU - Nagy, Peter

AU - Panei, Pietro

AU - Romaniello, Roberta

AU - Usala, Tatiana

AU - Wong, Ian C. K.

AU - Banaschewski, Tobias

AU - Sonuga-Barke, Edmund

AU - Coghill, David

AU - Zuddas, Alessandro

AU - The ADDUCE Consortium

N1 - The research leading to these results received support from the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement numbers 260576 (ADDUCE). Copyright © 2020. Published by Elsevier Ltd.

PY - 2021/1

Y1 - 2021/1

N2 - 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.

AB - 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.

KW - Attention deficit/hyperactivity disorder (ADHD)

KW - methylphenidate

KW - stimulants

KW - height

KW - weight

KW - growth

KW - puberty

U2 - 10.1016/j.neubiorev.2020.09.031

DO - 10.1016/j.neubiorev.2020.09.031

M3 - Review article

C2 - 33080250

SN - 0149-7634

VL - 120

SP - 509

EP - 525

JO - Neuroscience and Biobehavioral Reviews

JF - Neuroscience and Biobehavioral Reviews

ER -