Children whose so-called "hyperactive" behaviour has worrying social, educational and family consequences, should initially be offered behavioural therapy and/or psychotherapy. If this is insufficient, methylphenidate is sometimes suggested, but its efficacy is limited and it causes adverse effects.

Methylphenidate is a psychostimulant drug in the amphetamine family. In the 1970s, it emerged that it hindered children’s growth and weight gain, probably due to its appetite suppressant effect, which increases as the dose is augmented. In 2010, evidence confirmed that the growth of children taking the drug is slowed by 1 cm to 1.5 cm each year, especially during the first year of treatment. After temporarily or permanently halting the treatment, the child’s growth appears to catch up after two years. Other treatments offered as an alternative to methylphenidate also carry the risk of stunting the patient’s growth.

Methylphenidate is only one recourse for some so-called "hyperactive" children. Renewing the prescription is the opportunity for a clinical examination and monitoring the child’s height. Halting the treatment or reducing the dosage should be considered if growth appears to be overly stunted.

©Prescrire 1 October 2011

"Methylphenidate: growth retardation" Prescrire Int 2011; 20 (120): 238-239. (pdf, subscribers only)