In a paper published in the journals Pediatrics, researchers reported on a study they performed, addressing the question of elevated obesity risk in children who are treated on medications for Attention Deficit Hyperactivity Disorder (ADHD). ADHD is a common psychiatric disorder in children; considered incurable, but currently treatable with psychoactive medications. Psychostimulants are the primary drug of choice used in treating ADHD. Counter-intuitively, although these medications stimulate the central nervous system, they have a calming effect on people with ADHD.
All psychoactive medications carry risks, some more significant than others. Patients with structural heart problems or pre-existing heart conditions are warned against use of the stimulant drugs. These drugs are associated with fatalities in children with heart problems, and with heart attack, stroke and sudden death in adults with heart conditions. The American Heart Association recommends that children have cardiac testing performed before being prescribed stimulants to treat ADHD.
Aside from possible cardiac complications, there are other risks associated with the use of the psychostimulants. These medications may exacerbate behaviors and thought disturbance in patients with a psychotic disorder. The medications may trigger manic episodes in patients who have both bipolar disorder and ADHD. The medications can also increase hostility or aggressive behavior. Milder side effects include headache, irritability, depression, stomach pain, lack of spontaneity and hair loss. Some children experience tics or jerky movement disorders. Sleeplessness, decreased appetite and nervousness are the most commonly seen side effects of the psychostimulants. Slow growth or weight gain is also seen in children taking psychostimulants.
Prevalence of ADHD (or detection) is on the rise: two million more children were diagnosed with ADHD in 2011 to 2012 than in 2003 to 2004. One million more children are taking medication for ADHD than before. A year ago, Medical News Today reported the results of a study showing that males with childhood ADHD are likely to have a greater body mass index (BMI) as adults. One feature of ADHD is poor impulse control which might lead to poor eating habits and weight gain. This leaves open the question, however, of whether the elevated risk of obesity is a consequence of ADHD itself, or the result of the medications used in the treatment of ADHD.
In order to answer this question, researchers from the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD completed a longitudinal study using data from an electronic health record database on 163,820 children from three to 18 years old. A longitudinal study is a form of research conducted over many years during which members of a study group are observed, so as to correlate measured variables with a particular outcome. In this study, the researchers were addressing the question of whether the use of stimulants for treatment of ADHD had any effect on Body Mass Index (BMI).
The researchers found that children with ADHD who were not medicated, or who were treated without stimulant medication had a faster BMI growth in childhood than children who were not diagnosed with ADHD. On the other hand, children with ADHD who were treated with stimulant medication had a slower BMI growth in early childhood, but as adolescents they demonstrated a more rapid BMI growth than normal children or children who were treated without stimulants. Also, researchers noted that this effect was stronger in children who were medicated earlier on the stimulant medications.
The researchers concluded that the previous findings of an elevated risk of obesity in children with ADHD are valid, but that the higher risk could be attributed to the use of stimulants to treat the disease, rather than to the disease itself. Implications of this research include providing important data for facilitating obesity prevention plans for children with ADHD.
By Laura Prendergast