Objective: To estimate long-term stimulant treatment associations on standardized height, weight, and body mass index trajectories from childhood to adulthood in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA). Method: Of 579 children with DSM-IV ADHD−combined type at baseline (aged 7.0–9.9 years) and 289 classmates (local normative comparison group [LNCG]), 568 and 258 respectively, were assessed 8 times over 16 years (final mean age = 24.7). Parent interview data established subgroups with self-selected Consistent (n = 53, 9%), Inconsistent (n = 374, 66%), and Negligible (n = 141, 25%) stimulant medication use, as well as patients starting stimulants prior to MTA entry (n = 211, 39%). Height and weight growth trajectories were calculated for each subgroup. Results: Height z scores trajectories differed among subgroups (F = 2.22, p <.0001) and by stimulant use prior to study entry (F = 2.22, p <.001). The subgroup-by-assessment interaction was significant (F = 2.81, p <.0001). Paired comparisons revealed significant subgroup differences at endpoint: Consistent was shorter than Negligible (−0.66 z units /−4.06 cm /1.6 inches, t = −3.17, p < 0.0016), Consistent shorter than Inconsistent (−0.45 z units /−2.74 cm /−1.08 inches, t = −2.39, p <.0172), and the Consistent shorter than LNCG (−0.54 z units/+3.34 cm/ 1.31 inches, t = −3.30, p < 0.001). Weight z scores initially diverged among subgroups, converged in adolescence, and then diverged again in adulthood when the Consistent outweighed the LNCG (+ 3.561 z units /+7.47 kg /+16.46 lb, p <.0001). Conclusion: Compared with those negligibly medicated and the LNCG, 16 years of consistent stimulant treatment of children with ADHD in the MTA was associated with changes in height trajectory, a reduction in adult height, and an increase in weight and body mass index. Clinical trial registration information: Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); https://clinicaltrials.gov/; NCT00000388.

Additional Metadata
Keywords ADHD, adult height, growth trajectory, longitudinal study, stimulant medication
Persistent URL dx.doi.org/10.1016/j.jaac.2019.06.019
Journal Journal of the American Academy of Child and Adolescent Psychiatry
Citation
Greenhill, L.L. (Laurence L.), Swanson, J.M. (James M.), Hechtman, L. (Lily), Waxmonsky, J. (James), Arnold, L.E. (L. Eugene), Molina, B.S.G. (Brooke S.G.), … Hanć, T. (Tomasz). (2019). Trajectories of Growth Associated With Long-Term Stimulant Medication in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry. doi:10.1016/j.jaac.2019.06.019