Ritalin and Growth

My eight-year-old daughter has recently been diagnosed with ADD. She presently takes 10mg of Ritalin twice daily, seven days a week. My concern is another physician informed me that by taking Ritalin seven days a week, it did not allow release of the growth hormone. Whereas, only taking it five days a week allowed adequate release of the growth hormone. Since this information is only available to physicians, (i.e. physician reference guides) I am concerned about the long-term effects of taking the medication 365 days a year. The results have been tremendous, but I want what is best for my daughter.

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

The use of Ritalin has increased substantially over the last four years. The reasons for this are many, but with this increased use, many physicians and researchers have also had renewed interest in better understanding the drug. Early in the 1970's, some researchers suggested that there might be a growth suppressant effect when ritalin was given in large doses. Later, studies looking specifically at this possible effect showed this did not seem to occur. But because of all the controversy surrounding this issue, the FDA, in 1979, working in conjunction with outside experts reviewed all the literature and came up with some conclusions:

  1. There does seem to be a temporary decrease in weight gain and possibly linear growth (height).

    HOWEVER

  2. This decrease does not significantly affect final adult stature or weight.

Since that time, several other studies have looked at growth of children who are on Ritalin, and most of them support the idea that Ritalin does not affect it. In fact, in 1987, the American Academy of Pediatrics put out a statement implying that the risk of growth suppression with stimulant use was no longer felt to be significant. It is interesting to note, however, that many experts who when discussing the side effects of Ritalin, acknowledge that it does not significantly effect growth, but still advise that each child who is taking Ritalin have their weight and height monitored.

Your question is an interesting one, in that, you are more interested in the effects Ritalin has on growth hormone rather than growth itself. Growth hormone has functions other than growth including keeping the blood sugar in the normal range. This was initially a concern to researchers and physicians as well because they knew that theoretically, Ritalin might affect growth hormone by indirect means. However, research done in the 1980's showed that, in fact, Ritalin has no effect on growth hormone.

I am happy to hear that the results of your daughter's treatment have been excellent. I suggest you discuss your concerns about your daughter's drug regimen with her doctor. Ritalin's effect on growth hormone does not seem to be a factor. But while the effect of Ritalin on a child's ultimate height does not seem to be significant either, I think the normal checking of height and weight during regular check-ups is a good idea. It is also a good idea to keep an eye on Ritalin's effect on appetite as it can clearly suppress this.

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