Children on ADHD drugs need regular check-ups to guard against potential side-effects affecting height and weight, doctors warn
Children taking popular ADHD medications like Ritalin and Vyvanse should get four key things tested every six months to guard against potential side-effects, doctors say.
Children on popular ADHD drugs have been warned to have their height and weight checked every six months because of potential side effects.
A new report from the Murdoch Children’s Research Institute has found the drugs are safe and effective, but children need to be monitored because the long-term effects of stimulants are not well understood.
Two leading Australian researchers and paediatricians, University of Melbourne Associate Professor Daryl Efron and Dr Nadia Coscini, advise children taking Attention Deficit Hyperactivity Disorder (ADHD) drugs should have ongoing monitoring of height, weight, heart rate and blood pressure, as well as their symptoms.
Dr Efron, lead author of the report in Australian Prescriber, said children should be monitored every six months.
It comes as an estimated one in 20 boys and two in 100 girls under 18 are prescribed ADHD medication such as Ritalin, Concerta, Vyvanse, Catapres and Intuniv, with around 70 per cent finding the drugs have a positive impact on their symptoms.
The report states that “consistent long-term stimulant use may negatively affect linear growth and adult height, highlighting the importance of regular monitoring and follow-up”.
Dr Efron, a senior research fellow from the Murdoch Children’s Research Institute, said the most common adverse effects of stimulants are appetite suppression, irritability, insomnia, abdominal pain and headache.
“Apart from appetite suppression, many of these adverse effects subside with time. Stimulants can exacerbate tics and anxiety, but the presence of these symptoms is not a contraindication to starting medication. A minority of children and adolescents may become subdued and less able to enjoy social interactions,” he said.
“Stimulants are associated with a slight mean increase in heart rate and blood pressure in children and adolescents, potentially increasing the risk of a cardiac event in children with cardiovascular risk factors, such as hypertension, or some types of cardiac disease.
“It is therefore important to monitor heart rate and blood pressure while on treatment and exclude cardiac symptoms or signs, such as a murmur, before starting medication.”
Between 5-10 per cent of children are diagnosed with ADHD, a neurodevelopmental disorder characterised by developmentally inappropriate levels of hyperactivity, impulsivity and/or inattention.
Dr Efron said children taking stimulants “typically pay attention longer, are less impulsive and have improved social skills”.
“Parents and teachers often report reduced emotional reaction to frustration and improved peer interactions,” he said.
“Most treated children take a stimulant every day, although some children or families prefer to use it predominantly on school days, and only as needed on weekends and during school holidays.”
A 2024 large international study, which included Australian data, found one-third of children and half of adolescents discontinue their ADHD medication within 12 months of starting due to adverse effects or lack of efficacy. Many start again.
“When treatment with ADHD medication is effective and well tolerated, it is typically continued for some years. If patients have been stable for some time and appear to be making developmental gains in attentional and impulse control, consideration should be given to stopping treatment,” Dr Efron said.
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Originally published as Children on ADHD drugs need regular check-ups to guard against potential side-effects affecting height and weight, doctors warn
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