March 15, 2003
Other Medications
Question from Atlanta, Georgia, USA:
Our nine year old son, who is on the insulin pump and has very good control, is also on Concerta [methylphenidate in an extended-release formulation] for ADD which he takes on school days. A lot of testing went into the diagnosis for ADD so we are confident he has that.
He also is growth hormone deficient. He had to undergo many, many tests with our previous insurer (HMO), it was determined he was deficient, and he went on growth hormone. He grew very, very well and went from below the 0 percentile to the 25th percentile so we took him off growth hormone for a year to see if he would grow without it, but he did not grow much (1/4 inch). The endocrinologist did a IGF test on him about months ago, and it was low so he went back on the growth hormone two months later and has grown an inch. We all expected a bit more growth than this and have heard many opinions on the effects of Concerta on growth.
How much does the Concerta take away from the growth hormone — are the two fighting each other? Does Concerta affect growth in a non growth hormone deficient child? Does Concerta affect growth in a deficient child on growth hormone ?
Answer:
The stimulants do affect appetite and can affect growth. I have a number of children on growth hormone and stimulants realizing they need both and accepting the risk/benefit ratio. I have seen children not gain weight for a worrisome interval on stimulants — maybe even some height too, but less of an effect. You have to make your choices. I tell parents that school is too important to risk.
LD
