Stimulant-related reductions of growth rates in the PATS

James Swanson, Laurence Greenhill, Tim Wigal, Scott Kollins, Annamarie Stehli, Mark Davies, Shirley Chuang, Benedetto Vitiello, Anne Skrobala, Kelly Posner, Howard Abikoff, Melvin Oatis, James McCracken, James McGough, Mark A Riddle, Jaswinder Ghuman, Charles Cunningham, Sharon Wigal

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To investigate growth of children with attention-deficit/ hyperactivity disorder (ADHD) in the Preschool ADHD Treatment Study (PATS) before and after initiation of treatment with methylphenidate at titrated doses (average, 14.2 mg/day) administered three times daily, 7 days/week for ≈1 year. METHOD: The heights and weights of 140 children with ADHD were measured up to 29 times in the PATS protocol, starting at an average age of 4.4 years. The relationship between standard (z) scores and time on medication was examined using mixed-effect regression to estimate change in relative size (slope). RESULTS: Average relative size at baseline was significantly (p <.0001) greater than zero for z height (+0.45) and z weight (+0.78), indicating greater than expected height (by 2.04 cm) and weight (by 1.78 kg). During treatment, slopes were significantly (p <.0001) less than zero for z height (-0.304/yr) and z weight (-0.530/yr), indicating reduction of growth rates. For 95 children who remained on medication, annual growth rates were 20.3% less than expected for height (5.41 cm/yr - 6.79 cm/yr = -1.38 cm/yr) and 55.2% for weight (1.07 kg/yr - 2.39 kg/yr = -1.32 kg/yr). CONCLUSIONS: Risks of reduced growth rates should be balanced against expected benefits when preschool-age children are treated with stimulant medication. Copyright 2006

Original languageEnglish (US)
Pages (from-to)1304-1313
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume45
Issue number11
DOIs
StatePublished - Nov 2006

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Weights and Measures
Attention Deficit Disorder with Hyperactivity
Growth
Therapeutics
Methylphenidate
Preschool Children
Clinical Protocols

Keywords

  • Attention-deficit/hyperactivity disorder
  • Growth
  • Stimulant medication

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

Cite this

Swanson, J., Greenhill, L., Wigal, T., Kollins, S., Stehli, A., Davies, M., ... Wigal, S. (2006). Stimulant-related reductions of growth rates in the PATS. Journal of the American Academy of Child and Adolescent Psychiatry, 45(11), 1304-1313. https://doi.org/10.1097/01.chi.0000235075.25038.5a

Stimulant-related reductions of growth rates in the PATS. / Swanson, James; Greenhill, Laurence; Wigal, Tim; Kollins, Scott; Stehli, Annamarie; Davies, Mark; Chuang, Shirley; Vitiello, Benedetto; Skrobala, Anne; Posner, Kelly; Abikoff, Howard; Oatis, Melvin; McCracken, James; McGough, James; Riddle, Mark A; Ghuman, Jaswinder; Cunningham, Charles; Wigal, Sharon.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 45, No. 11, 11.2006, p. 1304-1313.

Research output: Contribution to journalArticle

Swanson, J, Greenhill, L, Wigal, T, Kollins, S, Stehli, A, Davies, M, Chuang, S, Vitiello, B, Skrobala, A, Posner, K, Abikoff, H, Oatis, M, McCracken, J, McGough, J, Riddle, MA, Ghuman, J, Cunningham, C & Wigal, S 2006, 'Stimulant-related reductions of growth rates in the PATS', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 45, no. 11, pp. 1304-1313. https://doi.org/10.1097/01.chi.0000235075.25038.5a
Swanson, James ; Greenhill, Laurence ; Wigal, Tim ; Kollins, Scott ; Stehli, Annamarie ; Davies, Mark ; Chuang, Shirley ; Vitiello, Benedetto ; Skrobala, Anne ; Posner, Kelly ; Abikoff, Howard ; Oatis, Melvin ; McCracken, James ; McGough, James ; Riddle, Mark A ; Ghuman, Jaswinder ; Cunningham, Charles ; Wigal, Sharon. / Stimulant-related reductions of growth rates in the PATS. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2006 ; Vol. 45, No. 11. pp. 1304-1313.
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abstract = "OBJECTIVE: To investigate growth of children with attention-deficit/ hyperactivity disorder (ADHD) in the Preschool ADHD Treatment Study (PATS) before and after initiation of treatment with methylphenidate at titrated doses (average, 14.2 mg/day) administered three times daily, 7 days/week for ≈1 year. METHOD: The heights and weights of 140 children with ADHD were measured up to 29 times in the PATS protocol, starting at an average age of 4.4 years. The relationship between standard (z) scores and time on medication was examined using mixed-effect regression to estimate change in relative size (slope). RESULTS: Average relative size at baseline was significantly (p <.0001) greater than zero for z height (+0.45) and z weight (+0.78), indicating greater than expected height (by 2.04 cm) and weight (by 1.78 kg). During treatment, slopes were significantly (p <.0001) less than zero for z height (-0.304/yr) and z weight (-0.530/yr), indicating reduction of growth rates. For 95 children who remained on medication, annual growth rates were 20.3{\%} less than expected for height (5.41 cm/yr - 6.79 cm/yr = -1.38 cm/yr) and 55.2{\%} for weight (1.07 kg/yr - 2.39 kg/yr = -1.32 kg/yr). CONCLUSIONS: Risks of reduced growth rates should be balanced against expected benefits when preschool-age children are treated with stimulant medication. Copyright 2006",
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