One of the most common childhood neurodevelopmental disorders, Attention Deficit Hyperactivity Disorder (ADHD), is usually treated with medications and behavioral therapy. A new study, however, suggests that children on medication for ADHD may have lower bone density compared to their peers.
Researchers from the U.S. Army Institute of Surgical Research examined more than 5,300 patients and compared children who took ADHD drugs with those who did not. They found that kids on medication had lower bone mineral density in the femur, femoral neck, and lumbar spine or lower back.
"This is an important step in understanding a medication class that is used with increasing frequency, and its effect on children who are at a critical time for building their bones," said Dr. Jessica Rivera, an orthopedic surgeon with the U.S. Army Institute of Surgical Research.
They presented the study at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
Link Between ADHD Meds And Osteopenia
About 25 percent of children on ADHD drugs met criteria for osteopenia, a condition wherein there is reduced bone mass of lesser severity than osteoporosis. Kids who use medications such as dexmethylphenidate (Focalin), methylphenidate (Ritalin), atomoxetine (Strattera), dextroamphetamine (Dexedrine) and lisdexamfetamine (Vyvanse).
The definite link between osteopenia in childhood and osteoporosis in later life has not been confirmed yet. Osteoporosis is characterized by decreased bone mass that increases the likelihood of brittle bones and fracture risk.
The drugs used to treat ADHD symptoms can lead to gastrointestinal problems, such as upset stomach and loss of appetite. This could lead to nutritional deficit and lower calcium intake. Another mechanism of the drug includes decreasing bone density by altering the sympathetic nervous system, which is responsible for bone regeneration and remodeling.
What Should Be Done?
Since most of these medications are given to growing children and most skeletal growth happens by the age of 20, the researchers urge doctors to include nutritional counseling in the treatment regimen of kids under these medications. Other preventive measures should also be considered as well as informing the parents about the risks of taking these medications.
"Parents of patients taking ADHD medications should be informed of potential bone loss, especially if the findings of this study are validated in prospective studies." said Dr. Rivera.
What Is ADHD?
Children Attention Deficit Hyperactivity Disordr (ADHD) may have trouble paying attention, controlling impulsive behaviors and may be hyperactive. Normally, children may have a problem in paying attention at one time or another but those with ADHD do not grow out of these behaviors.
The symptoms may continue and cause difficulty at home and in school. Common signs and symptoms include daydreaming a lot, being forgetful, squirming, fidgeting, having trouble taking turns, and they have a difficulty getting along with others.
ADHD By The Numbers
ADHD is one of the most common neurobehavioral condition usually diagnosed in childhood. According to the U.S. Centers for Disease Control and Prevention (CDC), about 6.4 million children were diagnosed with ADHD through 2011.
The number of kids diagnosed with ADHD continues to increase from 7.8 percent in 2003 to 9.5 percent in 2011 and 11 percent in 2011. The condition affects boys more than girls. About 13.2 percent of boys are affected compared to 5.6 percent of girls.
On average, ADHD is diagnosed when children reach 7 years old and the state with the highest prevalence of ADHD is Kentucky with 18.7 percent. Nevada, on the other hand, has the lowest prevalence with 5.6 percent.