Human Nature

Shrink Drugs

If you put your kid on ADHD drugs, what will you have to show for it three years later?

Maybe just a smaller kid.

Shankar Vedantam outlines the unpleasant findings in the Washington Post :

New data from a large federal study have reignited a debate over the effectiveness of long-term drug treatment of children with hyperactivity or attention-deficit disorder, and have drawn accusations that some members of the research team have sought to play down evidence that medications do little good beyond 24 months. The study also indicated that long-term use of the drugs can stunt children’s growth.

In the early stages of the project, known as the Multimodal Treatment Study of Children With ADHD , the drugs looked good. But as years went by, the benefits faded, and the only remaining effect was, in relative terms, physical shrinkage:

In August 2007, the MTA researchers reported the first follow-up data, which by then no longer showed differences in behavior between children who were medicated and those who were not. But the data did show that children who took the drugs for 36 months were about an inch shorter and six pounds lighter than those who did not.

Here’s the report published by the study’s supervisors in 2007:

The newly medicated subgroup showed decreases in relative size that reached asymptotes by the 36-month assessment, when this group showed average growth of 2.0 cm and 2.7 kg less than the not medicated subgroup, which showed slight increases in relative size.
Conclusions: Stimulant-naive school-age children with Combined type attention-deficit/hyperactivity disorder … show stimulant-related decreases in growth rates after initiation of treatment, which appeared to reach asymptotes within 3 years without evidence of growth rebound.

Without evidence of growth rebound . You lose two centimeters of expected growth—more than three-quarters of an inch—and you don’t get them back. That’s nowhere close to the two feet of height you can withhold from a prepubescent girl through estrogen therapy . But it’s just as permanent.

And how did the study’s funder, the National Institute of Mental Health , spin the bad news? Vedantam tweaks the Institute for its truth-stretching headline—” Improvement Following ADHD Treatment Sustained in Most Children “—and for euphemistically reporting that kids who weren’t drugged “grew somewhat larger.”

This study won’t settle the debate over ADHD drugs. But it should sober anyone who thinks that medicating the mind won’t affect the body—or that the effects can be erased.