ANS51(4)140-146 - ACTIVITAS Activitas Nervosa Superior...

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Activitas Nervosa Superior 2009; 51 :4,140-146 140 E FFECT OF S TIMULANTS ON G ROWTH OF ADHD C HILDREN : A C RITICAL R EVIEW Radek Ptacek * , Hana Kuzelova, Ivo Paclt Center for Neuropsychiatric Research of Traumatic Stress & Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic Received July 10, 2009; accepted September 2, 2009 Abstract Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood psychiatric disorders manifested in almost every part of children’s behavior. The most common treatment of ADHD is medication with stimu- lants, by specific amphetamine and methylphenidate. It is known that the treatment by stimulants may be accompanied by side effects from among decrease of appetite or changes in development as growth suppression and loss of weight which may present very serious phenomenon. Although many studies have monitored changes in growth and weight dur- ing medication, they did not provide definite results that the growth and weight suppression are caused by medication or not. According to many studies the height deficit is approximately amounted to 1 cm/year during the first 3 years of the treatment and can be clinically serious. Contrary to these findings some authors reported that the growth or weight changes can be a natural symptom of ADHD and not just a consequence of medication. The present article reviews key studies monitoring changes in parameters of growth in medicated children with ADHD, compares their results and sug- gest methodology improvements for further studies. Key words: ADHD; Hyperactivity; Attention disorders; Stimulants; Anthropometry; Growth INTRODUCTION Attention-deficit and hyperactivity disorder (ADHD) is one of the most common childhood disorders, characterized by developmentally inappropriate cognitive deficits, levels of inattention and/or hyperactivity/impulsivity (Kaiser et al., 2008; Barkely & Macias, 2005). The disorder is represented by a multiple loci of pathology with respect to atypical functional anatomy and pathophysiology. Cognitive deficits extend beyond executive functioning to include spatial, temporal, and lower-level „nonexecutive” functions. Atypical functional anatomy extends beyond frontostriatal circuits to include posterior cortices, limbic regions, and the cerebellum and pathophysiology includes dopaminergic as well as noradrenergic neurotransmitter systems (Vaidya & Stollstorff, 2008; Fassbender & Schweitzer, 2006; Roth & Saykin, 2004). Evidence-based treatments for ADHD include medication, psychotherapeutic and psychosocial methods or combination of these (Kaiser et al. 2008), whereas the combination seems to be the most effective (Jensen, 2009; So, 2008; Kaiser et al., 2008; Drtilkova, 2003; Paclt & Florian, 1996). Despite this fact, single use of stimulants is the most frequent treatment method in common clinical practice (Barkley et al., 1999; Barkely & Macias, 2005; Poulton, 2005). Positive
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This note was uploaded on 03/08/2011 for the course CLNICAL PS 2010 taught by Professor Actnervsuper during the Spring '11 term at The Chicago School of Prof. Psychology.

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ANS51(4)140-146 - ACTIVITAS Activitas Nervosa Superior...

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