Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
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A Study about Long-Term Effects of Attention-Deficit Hyperactivity Disorder Medication on Height and Weight in the Korean School-Aged Boys with Attention-Deficit Hyperactivity Disorder Based on Observation of Natural Course

자연경과 관찰에 의한 주의력결핍 과잉행동장애 아동에서 장기간의 약물치료가 성장에 미치는 영향

  • Yeom, Chan-Woo (Department of Neuropsychiatry, Eulji General Hospital, Eulji University School of Medicine) ;
  • Eun, Tae-Kyung (Department of Neuropsychiatry, Eulji General Hospital, Eulji University School of Medicine) ;
  • Park, Hoon-Sub (Department of Neuropsychiatry, Eulji General Hospital, Eulji University School of Medicine) ;
  • Lee, Kyu-Young (Department of Neuropsychiatry, Eulji General Hospital, Eulji University School of Medicine) ;
  • Kim, Eui-Joong (Department of Neuropsychiatry, Eulji General Hospital, Eulji University School of Medicine) ;
  • Joo, Eun-Jeong (Department of Neuropsychiatry, Eulji General Hospital, Eulji University School of Medicine) ;
  • Koo, Young-Jin (Department of Child and Adolescent Psychiatry, Eulji General Hospital, Eulji University School of Medicine)
  • 염찬우 (을지대학교 의과대학 을지병원 정신건강의학교실) ;
  • 은태경 (을지대학교 의과대학 을지병원 정신건강의학교실) ;
  • 박훈섭 (을지대학교 의과대학 을지병원 정신건강의학교실) ;
  • 이규영 (을지대학교 의과대학 을지병원 정신건강의학교실) ;
  • 김의중 (을지대학교 의과대학 을지병원 정신건강의학교실) ;
  • 주은정 (을지대학교 의과대학 을지병원 정신건강의학교실) ;
  • 구영진 (을지대학교 의과대학 을지병원 정신건강의학교실 소아청소년 클리닉)
  • Received : 2014.02.17
  • Accepted : 2014.05.24
  • Published : 2014.06.30
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Abstract

Objectives : This study was conducted naturalistically in order to observe the long-term effects of attention-deficit hyperactivity disorder (ADHD) medications on growth rates among Korean school-aged boys with ADHD. Methods : Participants in the study were boys with ADHD aged 6 to 11 years who have taken ADHD medication, methylphenidate (extended release) or atomoxetine. They attended scheduled visits monthly or bimonthly for clinical assessment with measurement of height and weight. In this study, 35 boys with ADHD (mean age at baseline=$7.90{\pm}1.77$ years ; mean age at endpoint= $12.54{\pm}1.91$ years) were included, with a mean follow-up period of 4.64 years (${\pm}1.62$ years), ranging from 2 to 9.7 years. Height, weight, and body mass index (BMI) measurements were converted to "age-corrected Z-scores" using data from Growth Charts provided by the Korean Center for Disease Control and Prevention from 2007. Results : Age-corrected endpoint growth parameters (height, weight, BMI Z-scores) did not differ significantly from the baseline values (height t=0.027 ; weight t=-0.61 ; BMI t=-1.86, in paired t-test). Especially high correlation was observed between the baseline and endpoint height Z-scores (r=0.876, p<.001), for which the coefficient of determination $r^2$ was 0.767, meaning that the amount of variability in endpoint height Z-scores explained by the baseline height Z-scores was 76.7%. Conclusion : Our results suggested that the long-term effects of ADHD medications on growth parameters to be tolerable in Korean school-aged boys with ADHD.

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References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association;2013.
  2. Yang SJ, Cheong S, Hong SD. Prevalence and correlates of attention deficit hyperactivity disorder: school-based mental health services in Seoul. J Korean Neuropsychiatr Assoc 2006;45:69-76.
  3. Yoo HJ, Yang SJ, Shin D, Kang H, Kim BN, Kim JH, et al. The Korean practice parameter for the treatment of attention-deficit hyperactivity disorder (III): pharmacologic treatment. J Korean Acad Child Adolesc Psychiatry 2007;18:16-25.
  4. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 2006;163:716-723. https://doi.org/10.1176/appi.ajp.163.4.716
  5. Safer DJ, Allen RP, Barr E. Growth rebound after termination of stimulant drugs. J Pediatr 1975;86:113-116. https://doi.org/10.1016/S0022-3476(75)80720-7
  6. Loney J, Whaley-Klahn MA, Ponto LB, Adney K. Predictors of adolescent height and weight in hyperkinetic boys treated with methylphenidate [proceedings]. Psychopharmacol Bull 1981;17:132-134.
  7. Mattes JA, Gittelman R. Growth of hyperactive children on maintenance regimen of methylphenidate. Arch Gen Psychiatry 1983;40: 317-321. https://doi.org/10.1001/archpsyc.1983.01790030087011
  8. Satterfield JH, Cantwell DP, Satterfield BT. Multimodality treatment. A one-year follow-up of 84 hyperactive boys. Arch Gen Psychiatry 1979;36:965-974. https://doi.org/10.1001/archpsyc.1979.01780090051006
  9. MTA Cooperative Group. National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: changes in effectiveness and growth after the end of treatment. Pediatrics 2004;113:762- 769. https://doi.org/10.1542/peds.113.4.762
  10. Spencer TJ, Biederman J, Harding M, O’Donnell D, Faraone SV, Wilens TE. Growth deficits in ADHD children revisited: evidence for disorder-associated growth delays? J Am Acad Child Adolesc Psychiatry 1996;35:1460-1469. https://doi.org/10.1097/00004583-199611000-00014
  11. Biederman J, Spencer TJ, Monuteaux MC, Faraone SV. A naturalistic 10-year prospective study of height and weight in children with attention-deficit hyperactivity disorder grown up: sex and treatment effects. J Pediatr 2010;157:635-640, 640.e1. https://doi.org/10.1016/j.jpeds.2010.04.025
  12. Spencer TJ, Kratochvil CJ, Sangal RB, Saylor KE, Bailey CE, Dunn DW, et al. Effects of atomoxetine on growth in children with attention- deficit/hyperactivity disorder following up to five years of treatment. J Child Adolesc Psychopharmacol 2007;17:689-700. https://doi.org/10.1089/cap.2006.0100
  13. Rogol AD, Roemmich JN, Clark PA. Growth at puberty. J Adolesc Health 2002;31(6 Suppl):192-200. https://doi.org/10.1016/S1054-139X(02)00485-8
  14. Korean Academy of Child and Adolescent Psychiatry. Adolescent Psychiatry. Seoul: Sigma Press;2012. p.16-24.
  15. Kim HW, Ko BJ, Park TW, Shin YO, Lee JS, Chung US, et al. Safety and tolerability of OROS methylphenidate for the treatment of ADHD. J Korean Acad Child Adolesc Psychiatry 2012;23 (Suppl):S24-S45.
  16. Bereket A, Turan S, Karaman MG, Haklar G, Ozbay F, Yazgan MY. Height, weight, IGF-I, IGFBP-3 and thyroid functions in prepubertal children with attention deficit hyperactivity disorder: effect of methylphenidate treatment. Horm Res 2005;63:159-164. https://doi.org/10.1159/000084683
  17. Graham J, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Dittmann RW, et al. European guidelines on managing adverse effects of medication for ADHD. Eur Child Adolesc Psychiatry 2011; 20:17-37. https://doi.org/10.1007/s00787-010-0140-6
  18. Korea Center for Disease Control and Prevention, The Committee for the Development of Growth Standard for Korean Children and Adolescents. 2007 Korean Children and Adolescents Growth Standard. Available from URL: http://www.cdc.go.kr.
  19. Spencer TJ, Faraone SV, Biederman J, Lerner M, Cooper KM, Zimmerman B, et al. Does prolonged therapy with a long-acting stimulant suppress growth in children with ADHD? J Am Acad Child Adolesc Psychiatry 2006;45:527-537. https://doi.org/10.1097/01.chi.0000205710.01690.d4
  20. Pliszka SR, Matthews TL, Braslow KJ, Watson MA. Comparative effects of methylphenidate and mixed salts amphetamine on height and weight in children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2006;45:520-526. https://doi.org/10.1097/01.chi.0000205702.48324.fd