. 2018 Oct 11;18(1):327.

doi: 10.1186/s12888-018-1884-7.

Effects of long-term methylphenidate use on growth and blood pressure: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

Suzanne McCarthy¹, Antje Neubert², Kenneth K C Man^{3

4

5}, Tobias Banaschewski⁶, Jan Buitelaar⁷, Sara Carucci⁸, David Coghill^{9

10

11}, Marina Danckaerts^{12

13}, Bruno Falissard¹⁴, Peter Garas¹⁵, Alexander Häge⁶, Chris Hollis¹⁶, Sarah Inglis¹⁷, Hanna Kovshoff¹⁸, Elizabeth Liddle^{16

19}, Konstantin Mechler⁶, Peter Nagy¹⁵, Eric Rosenthal²⁰, Robert Schlack²¹, Edmund Sonuga-Barke^{22

23}, Alessandro Zuddas⁸, Ian C K Wong^{3

24}

Affiliations

¹ School of Pharmacy, University College Cork, Cork, Ireland. s.mccarthy@ucc.ie.
² Department of Paediatrics and Adolescents Medicine, University Hospital Erlangen, Erlangen, Germany.
³ Centre for Paediatric Pharmacy Research, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
⁴ Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
⁵ Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands.
⁶ Department of Child & Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
⁷ Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, & Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
⁸ Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Science, University of Cagliari & "A. Cao" Pediatric Hospital, Brotzu Hospital Trust, Cagliari, Italy.
⁹ Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
¹⁰ Murdoch Children's Research Institute, Melbourne, Australia.
¹¹ Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK.
¹² Department of Child and Adolescent Psychiatry, University Psychiatric Center, Leuven, KU, Belgium.
¹³ Department of Neurosciences, University Psychiatric Center, Leuven, KU, Belgium.
¹⁴ University Paris-Sud, Univ. Paris-Descartes, AP-HP, INSERM U1178, Paris, France.
¹⁵ Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary.
¹⁶ Division of Psychiatry and Applied Psychology, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.
¹⁷ Tayside Clinical Trials Unit, University of Dundee, Dundee, UK.
¹⁸ Department of Psychology, University of Southampton, Southampton, UK.
¹⁹ Institute of Mental Health, Nottingham, UK.
²⁰ Department of Paediatric Cardiology, Evelina Children's Hospital, St Thomas' Hospital, London, UK.
²¹ Unit of Mental Health Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany.
²² Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK.
²³ Department of Experimental Clinical & Health Psychology, Ghent University, Ghent, Belgium.
²⁴ Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.

PMID: 30305167
PMCID: PMC6180569
DOI: 10.1186/s12888-018-1884-7

Effects of long-term methylphenidate use on growth and blood pressure: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

Suzanne McCarthy et al. BMC Psychiatry. 2018.

. 2018 Oct 11;18(1):327.

doi: 10.1186/s12888-018-1884-7.

Authors

Affiliations

¹ School of Pharmacy, University College Cork, Cork, Ireland. s.mccarthy@ucc.ie.
² Department of Paediatrics and Adolescents Medicine, University Hospital Erlangen, Erlangen, Germany.
³ Centre for Paediatric Pharmacy Research, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
⁴ Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
⁵ Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands.
⁶ Department of Child & Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
⁷ Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, & Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.
⁸ Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Science, University of Cagliari & "A. Cao" Pediatric Hospital, Brotzu Hospital Trust, Cagliari, Italy.
⁹ Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
¹⁰ Murdoch Children's Research Institute, Melbourne, Australia.
¹¹ Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK.
¹² Department of Child and Adolescent Psychiatry, University Psychiatric Center, Leuven, KU, Belgium.
¹³ Department of Neurosciences, University Psychiatric Center, Leuven, KU, Belgium.
¹⁴ University Paris-Sud, Univ. Paris-Descartes, AP-HP, INSERM U1178, Paris, France.
¹⁵ Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary.
¹⁶ Division of Psychiatry and Applied Psychology, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.
¹⁷ Tayside Clinical Trials Unit, University of Dundee, Dundee, UK.
¹⁸ Department of Psychology, University of Southampton, Southampton, UK.
¹⁹ Institute of Mental Health, Nottingham, UK.
²⁰ Department of Paediatric Cardiology, Evelina Children's Hospital, St Thomas' Hospital, London, UK.
²¹ Unit of Mental Health Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany.
²² Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK.
²³ Department of Experimental Clinical & Health Psychology, Ghent University, Ghent, Belgium.
²⁴ Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.

PMID: 30305167
PMCID: PMC6180569
DOI: 10.1186/s12888-018-1884-7

Abstract

Background: Concerns have been raised over the safety of methylphenidate (MPH), with regard to adverse effects on growth and blood pressure. Our study investigates whether, and to what extent, methylphenidate use in boys with ADHD is associated with having low body mass index (BMI), having low height, and increased systolic and diastolic blood pressure.

Methods: Data used for this study stem from the German KiGGS dataset. Three different groups of boys aged 6-15 years were included in the analysis: ADHD patients who used MPH for less than 12 months; ADHD patients who used MPH for 12 months or more; and ADHD patients without current MPH treatment. Each of these three groups was compared to a non-ADHD control group regarding low weight (BMI ≤ 3rd percentile), low height (≤3rd percentile) and raised systolic and diastolic blood pressure. For growth outcomes, boys were categorized according to age (< 11 years/≥11 years, to account for pubertal maturation). Multivariable logistic regression was conducted to test for associations.

Results: 4244 boys were included in the study; MPH < 12 months: n = 65 (n = 36 < 11 years), MPH ≥ 12 months: n = 53 (n = 22 < 11 years), ADHD controls: n = 320 (n = 132 < 11 years), non-ADHD controls: n = 3806 (n = 2003 < 11 years). Pre-pubertal boys with MPH use less than 12 months and pubertal/postpubertal boys with MPH use of 12 months or greater were significantly more likely to have a BMI ≤ 3rd percentile compared to non-ADHD controls. Boys from the ADHD control group were significantly less likely to have a raised systolic blood pressure compared to non-ADHD controls. Beyond that, no significant between group differences were observed for any other growth and BP parameter.

Conclusion: The analyses of the KiGGS dataset showed that MPH use in boys with ADHD is associated with low BMI. However, this effect was only observed in certain groups. Furthermore, our analysis was unable to confirm that MPH use is also associated with low height (≤3rd percentile) and changes in blood pressure.

Keywords: ADHD; BMI; Blood pressure; Growth; Methylphenidate; Safety.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The KiGGS survey was approved by the Charité Universitätsmedizin, Berlin ethics committee (no.: 101/2000) of the Virchow Hospital, Humboldt University Berlin and Federal Office for the Protection of the Data (no.: IV-401/008#0008). Written, informed consent was obtained prior to each interview and examination from the children’s parents and the children themselves if they were aged ≥14 years.

Consent for publication

Not applicable.

Competing interests

ESB: Financial.

Speaker fees, consultancy, research funding and conference support from Shire Pharma. Speaker fees from American University of Beirut, Janssen Cilag, Consultancy from Neurotech solutions, Copenhagen University and Berhanderling, Skolerne, KU Leuven. Book royalties from OUP and Jessica Kingsley. Financial support received from Arrhus Univeristy and Ghent University for visiting Professorship. Grants awarded from MRC, ESRC, Wellcome Trust, Solent NHS Trust, European Union, Child Health Research Foundation New Zealand, NIHR, Nuffield Foundation, Fonds Wetenschappelijk Onderzoek-Vlaanderen (FWO), MQ – Transforming Mental health. Editor-in-Chief JCPP – supported by a buy-out of time to University of Southampton and personal Honorarium.

Non-financial.

Member of the European ADHD Guidelines Group.

TB: Dr. Banaschewski served in an advisory or consultancy role for Actelion, Hexal Pharma, Lilly, Medice, Novartis, Oxford outcomes, PCM scientific, Shire and Viforpharma. He received conference support or speaker’s fee by Medice, Novartis and Shire. He is/has been involved in clinical trials conducted by Shire & Viforpharma. He received royalities from Hogrefe, Kohlhammer, CIP Medien, Oxford University Press. The present work is unrelated to the above grants and relationships.

JB: Jan K Buitelaar has been in the past 3 years a consultant to / member of advisory board of /.

and/or speaker for Janssen Cilag BV, Eli Lilly, Lundbeck, Shire, Roche, Medice, Novartis,

and Servier. He has received research support from Roche and Vifor. He is not an employee.

of any of these companies, and not a stock shareholder of any of these companies. He has no.

other financial or material support, including expert testimony, patents, royalties.

SC: During the last three years collaboration within projects from the European Union (7th Framework Program) and collaboration as sub-investigator in sponsored clinical trials by Shire Pharmaceutical Company. Travel support from Shire Pharmaceutical Company.

DC: Prof. Coghill reports grants from European Commission, during the conduct of the study; grants and personal fees from Shire, personal fees from Eli Lilly, grants from Vifor, personal fees from Novartis, personal fees from Oxford University Press, other than the EC grants these are all outside the submitted work.

MD: MD is a member of the European ADHD Guideline Group (EAGG) and holds grants from the European Union FP7 programme.

BF: The author declares that they have no conflict of interest.

PG: The author declares that they have no conflict of interest.

CH: Grants from European Union FP7 programme, H2020, National Institute of Health Research (NIHR) and Medical Research Council (MRC) during the conduct of the study; CH is a member of the European ADHD Guideline Group (EAGG) and NICE ADHD Guideline Committee.

SI: The author declares that they have no conflict of interest.

HK: The author declares that they have no conflict of interest.

EL: The author declares that they have no conflict of interest.

K KC M: The author declares that they have no conflict of interest.

KM: The author declares that they have no conflict of interest.

SM: Dr. McCarthy has received speaker’s fee, travel support and research support from Shire.

AN: The author declares that they have no conflict of interest.

PN: The author declares that they have no conflict of interest.

ER: The author declares that they have no conflict of interest.

RS: The author declares that they have no conflict of interest.

AH: A. Häge received speakers’ fees, was on advisory boards or has been involved in clinical trials by Shire, Janssen-Cilag, Otsuka, Lundbeck and Servier.

AZ: Dr. Zuddas served in an advisory or consultancy role for Angelini, Lundbeck, Otsuka, EduPharma, Shire and Viforpharma. He received conference support or speaker’s fee by Angelini and EduPharma. He is/has been involved in clinical trials conducted by Roche, Lundbeck, Shire & Viforpharma. He received royalities from Oxford University Press and Giunti OS. The present work is unrelated to the above grants and relationships.

ICKW: Prof. Wong reports grants from European Union FP7 programme, during the conduct of the study; grants from Shire, grants from Janssen-Cilag, grants from Eli-Lily, grants from Pfizer, outside the submitted work; and Prof Wong was a member of the National Institute for Health and Clinical Excellence (NICE) ADHD Guideline Group and the British Association for Psychopharmacology ADHD guideline group and acted as an advisor to Shire.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Effects of long-term methylphenidate use on growth and blood pressure: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

Affiliations

Effects of long-term methylphenidate use on growth and blood pressure: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

Authors

Affiliations

Abstract

Conflict of interest statement

Ethics approval and consent to participate

Consent for publication

Competing interests

Publisher’s Note

References

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical