The Effects Of Methylphenidate And Atomoxetine On Physical Growth Indexes Of School-aged Children And Adolescents With Attention Deficit/Hyperactivity Disorder

Aim: To determine the effects of MPH and ATX on physical growth of school-aged children and adolescents with ADHD.Methods: The medical records of 86 participants(average age 8.9±2.2years)with ADHD who prescribed medication(MPH or ATX)≥24 weeks in ADHD Specialist outpatient of Children’s Hospital of Chongqing Medical University were analyzed.WHO Anthro plus software(2007 WHO Children’s Physical Growth Standard)was used to convert the height,weight,and BMI data from each follow-up into age-and sex-adjusted Z-scores.T-test was used to analyze the changes of Z-scores after 6 months of drug therapy and the relationship between drug types and the occurrence of appetite loss.Linear fitting was used to analyze the variation trends of Z-scores of physical measurements during a period of drug treatment.Multiple linear regression was used to analyze the influencing factors of Z-scores of physical growth indexes during the treatment of MPH,and stepwise screening method was used for variable screening.Results: The Z-scores of initial height,weight,and BMI of ADHD children decreased significantly after the first 6 months of MPH treatment(P<0.001);the height Z-scores of children with ADHD decreased significantly after initial six months of ATX treatment(P<0.001),but the decrease in weight and BMI was not statistically significant(P>0.05).The Z-scores of height,weight and BMI of children treated with MPH decreased for the first six months(slopes of fitting lines were-0.18,-0.58and-0.69,respectively);throughout the entire treatment,they returned to-0.027,-0.26 and-0.20,respectively.In the first 6 months of ATX treatment,the slope of the Z-scores fitting line for the children’s height was a small negative value,but the fitting line slopes of the Z-scores for weight and BMI did not change significantly.The slopes of the fitting line of the physical growth indexes of ADHD children during the whole course of ATX was positive.The heights of ADHD children increased at a low rate(4.87cm/ year)during the first 6 months of treatment,but accelerated significantly at 6th to 18 th months,18 th to 30 th months,and after 30 th months(5.41cm/year,5.59cm/year,and 5.52cm/year,respectively).Loss of appetite(57%)were common self-reported side effects in children with ADHD during medication.The children taking MPH were more likely to report decreased appetite(P<0.05).The weight and BMI of the children receiving MPH were significantly correlated with decreased appetite(P<0.01).Conclusion: Compared with ATX,MPH had a greater negative effect on the physical growth indexes of children with ADHD and the negative effect gradually decreased with the extension of the treatment course.It is necessary for clinicians to pay attention to children’s diet during treatment.