Methylphenidate v.s. Growth in the long term - Please share your DC's experience 🙏

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Hi, for us as parents, there's always the unshakable layer of guilt for having to let our DC use medication. Lots of us started before their puberty kicks in.

My DC started Methylphenidate XL since February. He has only put on 1kg after all these months, with an increase of height 1cm (just lately too).

He's always been in the top 10 percentile for height and wearing clothes two years ahead of his age. But now he dropped to 70% and I worry if he would keep sliding down the scale...

Would love to hear your experience if your DC has been on medication for a few years. Are they able to overcome the effect of the drug and grow normally? Thank you.

What stage of puberty is he at? Would you have expected a growth spurt yet?

We delayed seeking Dx for DD because she was already seeing the endocrinologist for growth issues (should have been 98th centile genetically and was that at birth - but had dropped to 2nd by the time she was 2.5 years and never moved above 9th centile until she hit puberty).

DD started methylphenidate end of June and has grown 1cm since then... she's 14 and should be pretty much at adult height.

Her younger cousin (12) has been on it for years and seems to have grown fairly normally so far - he was taller than DD until this year, but is still pre-puberty. He is very, very slim. Giant genes in the family so he should be well over 6ft so will be interesting to see what happens.

Believe me the guilt goes both ways - we knew DD was ADHD since she was 5, and had I known the difference meds make to her, I would have probably thought sod the extra inches and got the Dx years ago. But the consultant was saying she might well not even make 5ft so I didn't want to add any extra risk factors. She's now 85th centile so there actually was room to play with.

Consultant seemed to think taking med breaks in holidays and weekends was important for things like growth.

@OhCrumbsWhereNow , thanks for sharing.

My DC just turned 11. So puberty is probably still a while away. - I just read an article mentioned about possibility of delay of puberty associated with ADHD medication. But, again, the evidence is not conclusive, as they also suspect if the delay is associated with ADHD condition per se.

Glad to know your DD is on the 85th centile now. That's very reassuring. I did go through some Reddit posts today and saw people commenting the negative effects on growth is not consistent and in the long run it's probably negligible. Quite a few research papers though quite conclusively pointed out the slow growth in the first at least 2-3 years, especially for girls. Very cloudy that is for the whole topic...

I know what you mean by wishing have had dx years earlier, if had known how life changing the med can be... There are lots of negative hues surrounding ADHD dx and the drugs. I think it's quite common for us to hesitate. Even after 8 months, I still sometimes dug really deeply trying to understand if there's more to the drug side effect than what I've learned already. The weight on the shoulder for having to make a decision is just quite heavy...

But yes, I do wish I have pushed harder earlier. Maybe two years earlier. That would have closed the gap between DC and their friends. But oh well, still a lot to sort out, as medication is not a cure-all after all.

We just finished the 11+ exams and started to let DC have weekend breaks, i.e. one day off and one day 1 short-release only. He just got too wild by the end of the day if not having any... Not sure if it's that has helped, but there seemed to be another kilo being added on within two weeks. Hopefully the trend can sustain...

Thank you for sharing. Hope your DD can reach her full potential with the help of the med. They are amazing kids. Good luck with everything!

That's really interesting about delayed puberty being associated with ADHD. My family is kind of vying to be the poster child for genetic inheritance - multiple incidences of ADHD, ASD and bipolar going back lots of generations - and a very strong history of both delayed puberty and constitutional delay of growth. But we're all also ridiculously tall (the shortest man is 6ft 4"!) DD is an outlier even on the 85th.

It's very hard to sort chicken from egg as well. DD doesn't make endocrine IGF-1... the ignition switch for the body to use growth hormone. Not having IGF-1 seems to affect sleep and appetite - she didn't eat proper food till she was 3.5 years and has NEVER slept. Never napped as a baby, could go 48 hours without sleep, bedtime has been midnight since she was about 2 and I gave up the fight. However, no sleep and refusing to eat doesn't exactly do wonders for growth either! Spent years seeing the top experts in Europe and they never managed to find any answers - most kids with no IGF-1 have Laron Syndrome, which is a rare form of dwarfism. They'd only seen one other child like my DD who had no IGF-1 but didn't have Laron Syndrome.

Obviously the sleep issues were probably just as much down to the ADHD as the endocrine stuff.

So you just end up going round and round in circles!

I had no clue just how well DD would respond to methylphenidate either - having seen the results I feel so bad that we didn't start in primary as she'd probably be far more likely to hit her academic potential in terms of GCSE grades. Instead we're very much playing catch up (happily school are very much onside and supportive).

Plus on the social front, they do all seem to be very young for age - DD is so much more mature and rational on the meds than off! I am slightly envious that school get all that and I get the evening rebound and the unmedicated weekends... I feel your pain on that front!

Sorry not to have any solid answers - only thing I know for sure on growth stuff is that it take years and years of them just getting data and sometimes even after 10 years of appointments you still have no answers. Bone age x-rays were interesting though - we knew from those that she had plenty of catch-up as her bones were 4 years delayed from chronological age, which suggested she'd be at the taller end of their estimates.

It's not something that's easy to get doctors to do though as it's not always in best interests to irradiate children! Fascinating though it might be.

Wishing you lots of luck with it all - and the 11+ results!