James G Waxmonsky1, William E Pelham5, Raman Baweja3, Daniel Hale4, William E Pelham5. 1. Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA. Electronic address: jwaxmonsky@pennstatehealth.psu.edu. 2. Center for Human Development, UC San Diego, La Jolla, CA. 3. Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA. 4. Department of Pediatric Endocrinology, Penn State College of Medicine, Hershey, PA. 5. Department of Psychology, Florida International University, Miami, FL.
Abstract
OBJECTIVE: To identify predictors of changes in height, weight, and body mass index (BMI) in children with attention deficit hyperactivity disorder (ADHD) starting central nervous system (CNS) stimulants. STUDY DESIGN: There were 230 medication-naïve children aged 5-12 years with ADHD who participated in a randomized trial evaluating the impact of CNS stimulants on growth over 30 months. This observational analysis focused on the 141 participants using study medication for 65 or more days in the first 6-months after starting medication. Biometric variables, ADHD, and oppositional defiant disorder symptom scores at medication initiation, and medication use over the study were examined as predictors of changes in standardized (z) height, weight, and BMI. RESULTS: Mean changes in z-BMI, z-weight. and z-height were negative throughout the study. The most consistent predictors of change in z-BMI, z-weight, and z-height were percent days medicated and total medication exposure. Children with lower z-height and z-weight at medication initiation experienced greater z-BMI and z-weight decreases over the first 6 months on medication. Greater appetite suppression during dose optimization predicted greater decreases in z-weight over the entire study and a greater decrease in z-height over the first 6 months on medication. z-weight change correlated with z-height change. Behavioral symptoms did not predict changes in z-BMI, z-weight, or z-height. CONCLUSIONS: How much and how often CNS stimulants are used predicts changes in z-BMI, z-weight, and z-height in children. Even smaller and lighter children may be at risk for decreases in z-weight and z-BMI. Parent ratings of appetite during dose titration may serve as feasible indicators of future weight and height change in children using CNS stimulants. TRIAL REGISTRATION: Clinicialtrials.gov: NCT01109849.
OBJECTIVE: To identify predictors of changes in height, weight, and body mass index (BMI) in children with attention deficit hyperactivity disorder (ADHD) starting central nervous system (CNS) stimulants. STUDY DESIGN: There were 230 medication-naïve children aged 5-12 years with ADHD who participated in a randomized trial evaluating the impact of CNS stimulants on growth over 30 months. This observational analysis focused on the 141 participants using study medication for 65 or more days in the first 6-months after starting medication. Biometric variables, ADHD, and oppositional defiant disorder symptom scores at medication initiation, and medication use over the study were examined as predictors of changes in standardized (z) height, weight, and BMI. RESULTS: Mean changes in z-BMI, z-weight. and z-height were negative throughout the study. The most consistent predictors of change in z-BMI, z-weight, and z-height were percent days medicated and total medication exposure. Children with lower z-height and z-weight at medication initiation experienced greater z-BMI and z-weight decreases over the first 6 months on medication. Greater appetite suppression during dose optimization predicted greater decreases in z-weight over the entire study and a greater decrease in z-height over the first 6 months on medication. z-weight change correlated with z-height change. Behavioral symptoms did not predict changes in z-BMI, z-weight, or z-height. CONCLUSIONS: How much and how often CNS stimulants are used predicts changes in z-BMI, z-weight, and z-height in children. Even smaller and lighter children may be at risk for decreases in z-weight and z-BMI. Parent ratings of appetite during dose titration may serve as feasible indicators of future weight and height change in children using CNS stimulants. TRIAL REGISTRATION: Clinicialtrials.gov: NCT01109849.
Authors: Brian S Schwartz; Lisa Bailey-Davis; Karen Bandeen-Roche; Jonathan Pollak; Annemarie G Hirsch; Claudia Nau; Ann Y Liu; Thomas A Glass Journal: Pediatrics Date: 2014-03-17 Impact factor: 7.124
Authors: 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 Riddle; Jaswinder Ghuman; Charles Cunningham; Sharon Wigal Journal: J Am Acad Child Adolesc Psychiatry Date: 2006-11 Impact factor: 8.829
Authors: Wonuola A Akingbuwa; Anke R Hammerschlag; Eshim S Jami; Andrea G Allegrini; Ville Karhunen; Hannah Sallis; Helga Ask; Ragna B Askeland; Bart Baselmans; Elizabeth Diemer; Fiona A Hagenbeek; Alexandra Havdahl; Jouke-Jan Hottenga; Hamdi Mbarek; Fernando Rivadeneira; Martin Tesli; Catharina van Beijsterveldt; Gerome Breen; Cathryn M Lewis; Anita Thapar; Dorret I Boomsma; Ralf Kuja-Halkola; Ted Reichborn-Kjennerud; Per Magnus; Kaili Rimfeld; Eivind Ystrom; Marjo-Riitta Jarvelin; Paul Lichtenstein; Sebastian Lundstrom; Marcus R Munafò; Robert Plomin; Henning Tiemeier; Michel G Nivard; Meike Bartels; Christel M Middeldorp Journal: JAMA Psychiatry Date: 2020-07-01 Impact factor: 21.596