Do ADHD meds lower bone density?

"This finding is important," says Alexis Feuer, "because we know that if you do not accrue peak bone density during adolescence and young adulthood, you're at a much higher risk for osteoporosis and fractures." (Credit: iStockphoto)

Researchers have found a link between medications commonly prescribed to treat children with attention deficit hyperactivity disorder and low bone density.

The findings suggest that the bone health of these kids should be monitored, since decreased bone density during childhood and early adulthood poses a greater risk for developing osteoporosis later in life.

An estimated 6.4 million children in the United States are affected by ADHD, and stimulants such as methylphenidate and amphetamine are widely prescribed for its treatment. Stimulants act through the sympathetic nervous system (SNS), which scientists now believe plays a role in bone remodeling, the normal process of removal and formation of bone.

In animal studies, activating the SNS lowers bone density, while studies of adult humans who take medications that block specific pathways in the SNS have shown an increase in bone density and a reduced risk of fracture.

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“We see many kids in our practice who are taking stimulants, and they usually come to us for either poor weight gain or poor linear growth,” says Alexis Feuer, assistant professor of pediatrics at Weill Cornell Medicine and pediatric endocrinologist at NewYork-Presbyterian/Weill Cornell Medical Center.

“Stimulant medications have been shown to slow the growth rate in children for a period of time during treatment, but the effects of stimulant use—if any—on the structure of bones in children remain largely unknown.”

To explore this, researchers used data from more than 6,000 participants ranging in age from 8 to 20 years old—159 of whom used stimulants—from the National Health and Nutrition Examination Study (NHANES) by the US Centers for Disease Control and Prevention.

The participants were scanned using an imaging technique called dual-energy X-ray absorptiometry to measure bone density in the femur and the lumbar spine, an area of the lower back.

The bone density of children who used stimulants was lower than children of the same age who didn’t use the medication.

“This finding is important,” Feuer says, “because we know that if you do not accrue peak bone density during adolescence and young adulthood, you’re at a much higher risk for osteoporosis and fractures.”

Other researchers from Weill Cornell Medicine, Columbia University, and the Children’s Hospital in Philadelphia are coauthors of the study that was presented last week at the annual meeting of the Endocrine Society.

Source: Cornell University