SAN DIEGO, Calif. -- Strattera (atomoxetine) given to children with attention deficit hyperactivity disorder does not appear to stunt growth over the long term, according to a lengthy study.
SAN DIEGO, Calif., Oct. 30 -- Strattera (atomoxetine) given to children with attention deficit hyperactivity disorder does not appear to stunt growth over the long term, according to a lengthy study.
Height, weight and body mass index (BMI) percentiles dropped initially with Strattera treatment but returned to pretreatment levels after three years of continual therapy, said Thomas J. Spencer, M.D., of Massachusetts General Hospital and Harvard Medical School, and colleagues, at the American Academy of Child and Adolescent Psychiatry meeting here.
"In many patients, the disorder persists through adolescence into adulthood and therefore may require chronic treatment," Dr. Spencer reported at a poster session. "Few studies have examined the effect of long-term pharmacological treatments for ADHD on growth, as most long-term trials have lasted only one to two years."
During the first 18 months of treatment, the children's height and weight had increased significantly less than expected on the basis on their initial percentiles for age and gender (P<0.05). Weight decrements persisted past 30 months (P<0.05).
However, after five years of treatment the researchers reported:
The study analyzed growth data for 1,312 patients at baseline with DSM-IV defined ADHD (mean age 11.0, range 6 to 17). They received Strattera at 1.8 mg/kg per day in an ongoing open-label treatment trial sponsored by Eli Lilly. At the five year point, only 61 patients remained (average age 10.2).
The researcher found that growth velocity appeared to have normalized for smaller-than-average and larger-than-average children after five years. The findings were:
The authors concluded that continual ADHD treatment may have minimal long-term effects.
"Individual patients, however, may show more or less pronounced effects," they wrote. "It is therefore important for clinicians to assess growth periodically during treatment, and for those patients who appear to be growing more slowly than expected, to consider whether treatment with atomoxetine is a factor."
The research was funded by Eli Lilly. Dr. Spencer reported research support and other financial relationships to Eli Lilly.