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Atomoxetine Unlikely to Have Long-Term Impact on Growth in Attention Deficit Hyperactivity Disorder: Presented at AACAP

By Paula Moyer

WASHINGTON, DC -- October 25, 2004 -- Treatment with atomoxetine (Strattera) is unlikely to adversely affect growth in children with attention deficit hyperactivity disorder (ADHD), according to findings presented here October 22^nd at the 51^st annual meeting of the American Academy of Child and Adolescent Psychiatry.

"We've been hearing a lot about the long-term effects of treatments for ADHD and whether the medications change the trajectory of a child's height and weight," said principal investigator Christopher J, Kratochvil, MD. "In this study we found no significant difference in a child's place on the height and weight curve before starting treatment and where they were several years later. After an initial weight loss, they catch up." Dr. Kratochvil is an associate professor of psychiatry at the Psychopharmacology Research Center at the University of Nebraska Medical Center.

In order to find out if atomoxetine had any effect on treated children's growth patterns, the researchers conducted a meta-analysis consisting of 203 patients with ADHD who had initially enrolled in placebo-controlled clinical trials of atomoxetine who went on to participate in long-term open-label extension studies. Therefore, the patients had been receiving atomoxetine for at least 3 years.

The patients were 6 to 16 years of age at the start of the treatment period and received up to 1.8 mg/kg of atomoxetine daily. The investigators analyzed the patients' weight and height measurements as actual values, percentiles, and z-scores. They calculated the patients' expected weight and height at endpoint by extrapolating from the patients' baseline percentiles. The percentiles were obtained from growth charts developed by the Centers for Disease Control and Prevention.

After 3 years of treatment, the children's height increased an average of 19.4 cm, which reflected a decrease of 1.4 percentiles relative to their baseline percentiles. The actual height gain at the three-year mark was 0.40 cm less than predicted by the growth charts. This difference was not statistically significant, Dr. Kratochvil said.

Similarly, the children's weight increased an average of 17.9 kg, which reflected an increase of 0.19 percentiles relative to the baseline percentile. The actual weight gain at the three-year mark was 0.52 kg more than predicted by the growth charts. (P = .896). Again, this difference between actual and predicted weight gain was not statistically significant, Dr. Kratochvil explained.

Interestingly, for both height and weight, the smallest children had a slight increase in their endpoint percentile, while patients in the highest quartile had a decrease in both measures. For both extremes, atomoxetine was associated with a slight normalisation of height and weight, but only slightly so, he said.

"It is important for clinicians to assess growth periodically during treatment," Dr. Kratochvil said. "For those patients who appear to be growing more slowly than expected, consider whether atomoxetine is a factor."


[Presentation title: Long-term effects of atomoxetine on growth in children with ADHD. Abstract: C3]

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