Prescribing medications for Attention Deficit Disorder has been called both an art and a science, since the type of medication and dosage both need to be carefully chosen by the prescribing physician. This is often based on trial and error. Until recently, the ways that stimulant medications work on the brains of people with ADD/ADHD were poorly understood. This lack of understanding and of precision in prescribing were two things that parents needed to consider before allowing pharmacological interventions. When parents are weighing the positive and negative impacts of using stimulant medication to subdue the negative symptoms of Attention Deficit Disorder, one consideration is also the effects that it could have on a child's growth. A study released in Pediatrics during 2014 examines this question.
Some background information about stimulant medications is helpful. When parents must consider the facts about stimulant medication, one thing that bothers many parents is that the way that stimulants improve attention and behavior has been poorly understood. Recent research done at Children's Hospital in Cincinnati showed that a child's genetic code plays a part in whether a stimulant medication will work to ameliorate the negative symptoms of ADD. In particular, the effect on dopamine was studied.
Dopamine helps in the regulation of information flow throughout the brain. It is a crucial factor in attention, and its lack in the frontal lobes is believed to be a partial causal factor in Attention Deficit Disorder. Methylphenidate (brand name Ritalin) has been shown to improve dopamine reception if a child lacks the DAT 10-repeat variant. This would be the reason a child would respond to methylphenidate with increased brain activation in the frontal lobes. One way that methylphenidate could improve frontal lobe functioning is due to the blocking action of the methylphenidate, which blocks both norepinephrine and dopamine transporters.
In addition to concerns about how stimulants work on brain chemistry, parents have long been worried about how children grow when they are taking stimulant medications. Many children find that the stimulant medications suppress their desire for food. The study that was published in Pediatrics compared adults who had taken medication as children with two other adults who were matched with them according to gender and age. They found that there was no significant deficit in final height in the adults who had taken medication. However, these people did have about a six-month delay in their peak growth spurt.
When considering stimulant medication for a child, many factors need to be weighed. However, it's good to know that long-term growth does not seem to be affected by stimulant medication that improves the frontal lobe functioning of children with Attention Deficit Disorder.
Anna Smith, Ana Cubillo, Nadia Barrett, Vincent Giampietro, Andrew Simmons, Mick Brammer, Katya Rubia. Neurofunctional Effects of Methylphenidate and Atomoxetine in Boys with Attention-Deficit/Hyperactivity Disorder During Time Discrimination. Biological Psychiatry, 2013; 74 (8): 615 DOI:10.1016/j.biopsych.2013.03.030
Elsevier. "How Do ADHD Medications Work?." ScienceDaily. ScienceDaily, 16 October 2013.
"More Evidence That ADHD Drugs Don't Curb Ultimate Height." KATHERINE HOBSON. Retrieved on September 01, 2014.
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