Children who rely on medication like Ritalin for attention deficit hyperactivity disorder (ADHD) could end up with lower bone density in their hips and lower back than their peers who don’t need the drug, American researchers are warning.
Texas scientists say their findings, released Thursday, are critical because it’s during childhood that kids forge good bone health and strength. Low-bone density at this stage could have long-term implications into adulthood.
“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 lead author, Dr. Jessica Rivera, an orthopedic surgeon at the U.S. Army Institute of Surgical Research.
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Rivera said that ADHD drugs are known to cause some gastrointestinal issues: an upset stomach and low appetite in some patients. The drugs could alter eating habits, affecting bone health during prime growing years of childhood and adolescence. Calcium intake can also be reduced.
“My message to parents is that this study opens a good door to discuss nutritional optimization for their children with their physicians,” she told Global News.
For her research, Rivera and her team looked at 5,315 kids who took part in a Centers for Disease Control and Prevention (CDC) survey. Their health data was stacked next to peers who take ADHD medications.
The drugs included Ritalin, Focalin, Dexedrine, Strattera and Vyvanse.
Novartis, Shire and Lilly – the makers of the ADHD drugs listed – have not responded to requests for comment from Global News.
Turns out, kids on ADHD meds had poor bone health in their hip bones (femur and femoral neck) and their lower back (lumbar spine). About 25 per cent of the group on ADHD medications fit the criteria for a condition called osteopenia, marked by having lower than normal bone density.
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Osteopenia in childhood doesn’t mean kids will go on to develop osteoporosis, which is when adults deal with brittle and porous bones, Rivera reassured parents.
She said her study is simply pointing to a link so it’s not known if it’s the medications that are to blame for kids’ thin bones.
“It is too early for parents to be alarmed because this is an early study that identified an association, not a cause and effect,” she said.
“What these numbers mean for long term is not known … I am not recommending any other changes in practice until additional research [is conducted] to better understand the risk is conducted.”
For now, she says parents and doctors should pay attention to kids’ bone health, which is typically overlooked until the later stages of life.
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Skeletal growth is complete by about 18 to 20 years old, so doctors should “realize the potential threat” ADHD meds could pose to maturing bones.
ADHD typically appears in kids in preschool or the early school years, according to Mental Health Canada. It’s hard for these kids to control their behaviour or pay attention. About three to five per cent of kids have ADHD, the organization says. That’s at least one child in a classroom of 25 to 30 kids.
Rivera’s full findings were published in the Journal of Pediatric Orthopaedics. She presented her work Thursday morning at the annual American Academy of Orthopaedic Surgeons meeting.