Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Ritalin and Delayed Growth | | | QUESTION | | | Dear Dr. Needlman,
I was recently made aware that a long-term side effect of Ritalin is affecting the growth of a child. My son, now 14, has been on Ritalin since 3rd grade. His height and weight always remained in the 65th percentile until the last two years, where it has slowed to the 10th percentile. We have spoken to his doctors, but they don't seem concerned. He has not hit puberty. My question is that if it does affect growth, are we too late to do anything about it? After seeing that article I took him off the Concerta. My son is an excellent athlete and an honor roll student. He is also adopted, so I don't know what exactly is in his background. Your opinion would be greatly appreciated.— Concerned Mom & Dad in Muncie, IN | | | ANSWER |
April 6, 2001 | | | Dear Concerned Mom & Dad,
Methylphenidate, which is the active ingredient in the brand-name medications Ritalin and Concerta, is well known to suppress the appetite and to cause a delay in growth. The consensus among experts is that this growth delay is small and related mostly, if not completely, to the decreased appetite. Many experts also think that children taking these medications reach their genetically determined normal height eventually, just a bit later than they might have otherwise.
Since your son has been taking methylphenidate for many years, during most of which time he was above average in height and weight, I doubt that this is a medication-related problem at all (unless his dose increased in the last two years, and he stopped eating normally). Much more likely, he is simply later than most boys his age in hitting his pubertal growth spurt. By 14 many of his classmates are already growth-spurting ahead. As a result, your son, who is slower to mature, looks like he is growing more slowly.
Children who are relatively late to start their grwoth spurts look "short" temporarily. Once their growth spurts kick in, they catch up. Later onset of puberty is not a methylphenidate side effect. Most often, it is completely normal, caused by genetics.
Without seeing your son, I of course can't make a firm diagnosis, but if his doctors aren't concerned, I'd bet they're thinking along the same lines. It's often tough for late-maturing boys, socially. Luckily, your son is an athlete and a star student. That should help a lot with self-esteem.— by Robert Needlman, M.D., F.A.A.P. |
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