The dangers of prolonged ADHD stimulant use in puberty
I'm aware a lot of people on here have taken or want to take ADHD medication for the benefits to focus it provides, but I've not seen any posts about the risks it poses to your development especially during puberty.
This thread is intended to detail how prolonged and regular use has been shown to be detrimental to height.
I am by no means saying that this is definite or 100% going to happen to you, simply presenting a danger shown in studies I've not seen mentioned on here before.
Thank you for reading, It was my first thread ever posted so I hope it was comprehensive and helpful to at least a couple of people out there as this information was for me.
I'm aware a lot of people on here have taken or want to take ADHD medication for the benefits to focus it provides, but I've not seen any posts about the risks it poses to your development especially during puberty.
This thread is intended to detail how prolonged and regular use has been shown to be detrimental to height.
I am by no means saying that this is definite or 100% going to happen to you, simply presenting a danger shown in studies I've not seen mentioned on here before.
Stimulants are a form of ADHD medication that aims to treat symptoms through increasing the levels of Dopamine and Norepinephrine present in your brain. These neurotransmitters are relevant because they work to control things like attention and mood in the case of Dopamine, as well as stress and alertness for Norepinephrine. [1]
There are two main stimulant sub types as well which is worth noting going forward.
Amphetamine-based (Adderall, Vyvanse, Amfexa etc):
- These work by releasing increased levels of the aforementioned neurotransmitters, and also regularing the reuptake and neutralisation of them to keep them in your brain for longer.
Methylphenidate-based (Ritalin, concertia etc):
- These work by solely regulating the reuptake of Dopamine and Norepinephrine, making them active for longer.
[2]
There are two main stimulant sub types as well which is worth noting going forward.
Amphetamine-based (Adderall, Vyvanse, Amfexa etc):
- These work by releasing increased levels of the aforementioned neurotransmitters, and also regularing the reuptake and neutralisation of them to keep them in your brain for longer.
Methylphenidate-based (Ritalin, concertia etc):
- These work by solely regulating the reuptake of Dopamine and Norepinephrine, making them active for longer.
[2]
Now that we have a broad understanding of neurochemistry behind stimulants we can break down the problem. That being that prolonged, regular use of stimulants has been shown in studies to stunt growth, particularly in adolescents. This side effect has been observed primarily from adolescent use every day for periods of time as low as 14 months. [3]
While Height was shown to rebound somewhat, this was only when they stopped use as children and could still grow. [4]
This distinction meaning that people who take stimulants all through childhood and do not stop until growth plate closure (usually 15-17) would not able to catch up in growth due to inability to grow past plate closure.
Bellow you can find both studies supporting this and also a caveat acknowledging the presence of studies that refute this as well.
- A study done took children that took methylphenidate aged 7-10 for 14 months and classified them into 3 groups, based on medication amounts taken by them "consistent", "inconsistent", and "negligent". They were followed to an average age of 25 years old, when measured those in the consistent dosage group were on average 4.7cm smaller than adults in the 'negligent' dosing group. [5]
- A study of 65 adolescent boys aged 12–16 years at recruitment and followed for a mean of 6.3 years concluded that stimulant medication does not delay the onset of puberty, but slows the rate of pubertal progression and delays the timing of peak growth velocity [6]
- In an observational study where subjects received stimulant medication for a mean of 6 years (up to 16 years), found the decrease in height z-scores was significant from baseline, with a total absolute reduction of 0.32. They report attenuation in the decrease in growth after 12–47 months of treatment, but baseline values were not reached even after 72 months [7]
- This study shows that once children were taken off methylphenidates for 1 year had no significant effect on height compared to children still on it, but after two years a significant effect on boosted height was seen in those children taken off the medication [8]
- In a study done on growth trajectories it was stated " Compared with those negligibly medicated and the LNCG (local normative comparison group), 16 years of consistent stimulant treatment of children with ADHD in the MTA study was associated with changes in height trajectory, a reduction of adult height" [9]
While Height was shown to rebound somewhat, this was only when they stopped use as children and could still grow. [4]
This distinction meaning that people who take stimulants all through childhood and do not stop until growth plate closure (usually 15-17) would not able to catch up in growth due to inability to grow past plate closure.
Bellow you can find both studies supporting this and also a caveat acknowledging the presence of studies that refute this as well.
- A study done took children that took methylphenidate aged 7-10 for 14 months and classified them into 3 groups, based on medication amounts taken by them "consistent", "inconsistent", and "negligent". They were followed to an average age of 25 years old, when measured those in the consistent dosage group were on average 4.7cm smaller than adults in the 'negligent' dosing group. [5]
- A study of 65 adolescent boys aged 12–16 years at recruitment and followed for a mean of 6.3 years concluded that stimulant medication does not delay the onset of puberty, but slows the rate of pubertal progression and delays the timing of peak growth velocity [6]
- In an observational study where subjects received stimulant medication for a mean of 6 years (up to 16 years), found the decrease in height z-scores was significant from baseline, with a total absolute reduction of 0.32. They report attenuation in the decrease in growth after 12–47 months of treatment, but baseline values were not reached even after 72 months [7]
- This study shows that once children were taken off methylphenidates for 1 year had no significant effect on height compared to children still on it, but after two years a significant effect on boosted height was seen in those children taken off the medication [8]
- In a study done on growth trajectories it was stated " Compared with those negligibly medicated and the LNCG (local normative comparison group), 16 years of consistent stimulant treatment of children with ADHD in the MTA study was associated with changes in height trajectory, a reduction of adult height" [9]
However, it would be unethical and irresponsible if I did not also mention that as many studies support this, there are also studies that found no significant variation, or that variation usually smoothed out over time. In my research the amount of studies for an against this height detriment were about half and half, however personally seeing some of these results I would not risk regular use of stimulants.
In addition most studies say that if medication is halted while still in puberty, a rebound is likely.
I will link some studies that did not find significant disparities to those interested.
- Concluded no significant changes in growth [10]
- Height difference found, but rebound if medication is halted also found [11]
In addition most studies say that if medication is halted while still in puberty, a rebound is likely.
I will link some studies that did not find significant disparities to those interested.
- Concluded no significant changes in growth [10]
- Height difference found, but rebound if medication is halted also found [11]
It is not fully understood why these patterns of height stunting in adolescents and adults who do not stop treatment are found. However some theories suggest that its a combination of:
- Dopamine being an inhibitor of GH production
- Appetite suppressant nature causing improper nutrient intake
- Some studies even suggest stimulants slow growth of cartilage, and therefore bones
[12]
- Dopamine being an inhibitor of GH production
- Appetite suppressant nature causing improper nutrient intake
- Some studies even suggest stimulants slow growth of cartilage, and therefore bones
[12]
While there are conflicting studies, a large number of studies report stimulants having a significant effect on the growth trajectory, and final adult height in people who use them regularly for a number of years. (as large as 4-5cm/2 inches different)
Fear not, these symptoms have been shown to reverse and rebound if usage of stimulants is stopped/broken up or made inconsistent as long as the person is still in adolescence. Obviously if your growth plates are closed stopped usage will not correct height as you can no longer grow.
There are still studies that also show limited effects on height, and show that careful adherence to dosage advice medication providers can negate this. However most people I know with adhd meds just pop them whenever they want, not following doctor advice carefully.
This is not meant to be medical advice, im simply just raising awareness for a risk ive not seen many people speak about and i was not informed of when I started my own stimulant prescription for my ADHD. As a result of my findings here ive switched over to dosing every day to once every few weeks/months whenever I need to work on projects or exams.
Fear not, these symptoms have been shown to reverse and rebound if usage of stimulants is stopped/broken up or made inconsistent as long as the person is still in adolescence. Obviously if your growth plates are closed stopped usage will not correct height as you can no longer grow.
There are still studies that also show limited effects on height, and show that careful adherence to dosage advice medication providers can negate this. However most people I know with adhd meds just pop them whenever they want, not following doctor advice carefully.
This is not meant to be medical advice, im simply just raising awareness for a risk ive not seen many people speak about and i was not informed of when I started my own stimulant prescription for my ADHD. As a result of my findings here ive switched over to dosing every day to once every few weeks/months whenever I need to work on projects or exams.
Thank you for reading, It was my first thread ever posted so I hope it was comprehensive and helpful to at least a couple of people out there as this information was for me.
