ADHD Medications and Growth Hormone Treatment

[MsMac]

Hello everyone, it has been a very long time since I have visited the boards. My son started growth hormone treatment and I put ADHD in the back of my mind. My son did take Metadate CD but I stopped given it to him before we he started growth hormone treatment. Last year he was in fight grade and didn't have too many problems not taking his meds. He did pretty well in class and made good grades. Now he is in sixth grade and it is a whole different world than elementary school! He is beginning to have major problems with organization and focusing. I talked with his IEP coordinator and she off the record said it may be a good idea to see about putting him back on medication.

I have been out of the loop for so long. Are there many new medications? He tried Concerta and he didn't eat and couldn't sleep while on it. Aderal made him wild. When he took Metadate CD his appetite was good and he slept well.

I was just reading a study that was written last month that showed ADHD medications do have an effect on height. He needs to be on medication but he also needs to grow all in can in the few years he has left to grow. He will be 12 on Saturday and has started puberty. Are there other kids here that are taking GHT and ADHD medications? How has it affected there response to growth hormone?

[Mayleng]

The study showed that the effect on height was minimum in the overall height - if it was the same study I read some time ago. (can you link me to the study?)


If your child did well on Metadate CD, and it did not affect his appetite than I doubt that it would affect his height. But I could be wrong. However, this question is probably best answered by the doctor who is prescribing the growth hormones.

[MsMac]

I have a call into the Ped. Endo. but they are terrible about returning calls. I was mainly wondering if there are other kids here that are also taking Growth Hormone.

The study was from the Journal of the
American Academy of Child & Adolescent Psychiatry, published in
August 2007.

"Effects of Stimulant Medication on Growth Rates Across 3 Years in
the MTA Follow-up"

Abstract:
Objective: To evaluate the hypothesis of stimulant medication effect
on physical growth in the follow-up phase of the Multimodal Treatment
Study of Children With ADHD.

Method: Naturalistic subgroups were established based on patterns of
treatment with stimulant medication at baseline, 14-, 24-, and 36-
month assessments: not medicated (n = 65), newly medicated (n = 88),
consistently medicated (n = 70), and inconsistently medicated (n =
147). Analysis of variance was used to evaluate effects of subgroup
and assessment time on measures of relative size (z scores) obtained
from growth norms.

Results: The subgroup x assessment time interaction was significant
for z height (p <.005) and z weight (p <.0001), due primarily to
divergence of the newly medicated and the not medicated subgroups.
These initially stimulant-naive subgroups had z scores significantly
>0 at baseline. The newly medicated subgroup showed decreases in
relative size that reached asymptotes by the 36-month assessment,
when this group showed average growth of 2.0 cm and 2.7 kg less than
the not medicated subgroup, which showed slight increases in relative
size.

Conclusions: Stimulant-naive school-age children with Combined type
attention-deficit/ hyperactivity disorder were, as a group, larger
than expected from norms before treatment but show stimulant-related
decreases in growth rates after initiation of treatment, which
appeared to reach asymptotes within 3 years without evidence of
growth rebound.

[Mayleng]

Thanks. I wish I could answer your question on the growth hormones etc, but I don't have experience with this.

I hope the Ped Endo. returns you call. Would appreciate if you keep us updated, this information may help someone else in the same boat.

[MsMac]

Here is another finding a mom with a growth hormone deficient child sent me. I guess there is no clear answer.

This was just published at the Endo07, the 89th annual conference of
the Endocrine Society.
============ ========= ========= ===
"Stunted growth in children with ADHD may not necessarily be due to
medication"

Children who are receiving medication to treat attention deficit
hyperactivity disorder (ADHD) and who are short for their age should
be tested for a hormonal cause of their short stature, the authors of
a new study recommend. The study will be presented Sunday, June 3, at
The Endocrine Society's 89th Annual Meeting in Toronto.

Slow growth in children taking stimulant medications for ADHD may not
be a side effect of the medication, as is commonly thought, cautioned
Dr. Samar Rahhal, a fellow in pediatric endocrinology at Indiana
University School of Medicine and a study author. Previous studies
have found that children taking stimulants experience slowing of
their growth, but most children eventually catch up and reach normal
adult heights.

Rahhal and her co-workers found that a significant number of children
referred to their university's pediatric endocrinology clinic for
evaluation of short stature are receiving ADHD medications, and many
of these children have a medical disorder responsible for poor growth.

The investigators randomly selected 120 medical records for review
from the records of 309 new patients who were 5 years of age or older
and were evaluated for poor growth. They found that 25 percent of the
patients were receiving medication to treat ADHD. This is an
unusually high percentage, Rahhal said. Only 5 percent of all
children in Indiana are currently medicated for ADHD, according to
the latest data from the U.S. Centers for Disease Control and
Prevention. Furthermore, they discovered that the children who were
medicated because of ADHD were just as likely as those who were not
prescribed these medications to have growth hormone deficiency (10
versus 13 percent, respectively) . Some of these children had other
growth disorders that required growth hormone therapy.

"If short stature is the effect of only ADHD medicine, you would not
expect to also see growth hormone deficiency in this many children,"
Rahhal said. "This study highlights the importance of thoroughly
screening short children with ADHD for endocrine diseases."

Parents and pediatricians should not assume the child will have catch-
up growth, she recommended, adding, "The child could have a growth
disorder as well."

[Mayleng]

My son has always been tall for his age, and his growth has not slowed after starting meds. He comes from a family of short people, so his being tall is unusual in our family.

There was another study I read (which I can't for the life of me find now) that states if stimulants affected the growth, it was minimal and the kids normally catch up to their normal height once medication has been stopped.

I would not be too concerned normally, but since your child is already on growth hormones, I don't know how stimulants might or might not affect him. I know the growth issue is also related to lack of appetite for some kids on stims. But if your child does not have that side effect on Metadate CD, it might not affect his growth.

See with the Endo Ped says.