ADHD Drugs Could Affect Kids’ Bone Health

Yet another challenge in treating the disorder — still, don't skip the meds

Stimulant drugs to treat attention-deficit hyperactivity disorder (ADHD) might be harming your children’s bones, a new study has shown.

Dr. Alexis Feuer, a pediatric endocrinologist at Weill Cornell Medicine in New York City, noted that stimulants such as methylphenidate and amphetamine (including Ritalin) could have an effect on bone density and mineral content.

ADHD affects more than 6 million children in the United States, according to the CDC. Feuer said that not having adequate bone mass by early adulthood could put kids at an increased risk for fractures or of developing osteoporosis later in life.

The study used data from 6,489 people ages 8 to 20 years who were part of the National Health and Nutrition Examination Survey (NHANES). Data was collected during the years 2005 to 2010. Participants underwent bone density scans with a dual-energy X-ray absorptiometry, or DXA, machine. Of them, 159 used stimulants.

Among stimulant users, the average bone mineral content at the lumbar spine was 5.1 percent lower than in nonusers and 5.3 percent lower at the hip. At the spine, bone density was 3.9 percent lower in stimulant users and 3.7 percent lower at the hip compared with nonusers.

Feuer said the study does not prove that ADHD medications cause lower bone density.

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“These results are cross-sectional, meaning bone density in all the children examined were only from one point in time. Therefore, we do not know if stimulant use actually caused a decrease in bone density, or if it simply an association,” Feuer told LifeZette, and called for more studies.

Can Parents Take Action?
Doctors should monitor the bone health of young patients on stimulants by checking body weight and height, encouraging weight-bearing exercise, and recommending adequate intake of calcium and vitamin D. Feuer said that routine imaging with DXA scans is not recommended at this time.

The International Society for Clinical Densitometry (ISCD) does not recommend routine DXA scanning, even on children with risk factors for low bone density such as chronic illness and those on medications known to cause reduced bone density (such as steroids and anti-epileptic drugs).

“It is not yet known if stimulants do, in fact, cause decreased bone mass in these children,” Feuer said. “It would be inappropriate to advise a parent not to give their child a stimulant if they need treatment with one.”

She added: “There are non-stimulant medications available, but their effects on bone density, if any, are also not known at this time.”

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