In this case, Dr. Findling and colleagues conducted a long-term, open-label safety analysis of the methylphenidate (MPH) transdermal system, a polymeric patch (Daytrana) that provides continuous release of the drug. The patch was used in children with ADHD aged 6 to 12 years and previously treated with the patch, or MPH extended release (ER) tablets, or placebo in a previous trials.
The children already receiving optimized doses of Daytrana continued on that dose for one year; those who were not receiving optimized doses increased their dosage for four weeks until they reached an optimal dose and were followed for 11 months afterward.
327 children were accepted into the study and of that number all but one were treated. It was found that after one month of treatment, researchers observed a decrease in weight in those who were taking the lower dose of MPH (10 mg and 15 mg). After about month five, 327 children began to approach baseline weight; only one child was below the lower limit of normal.
Overall, the children demonstrated normal growth in height and weight but not in BMI. At the end of the one year study, the average gain in growth was 1.5 inches; an increase in weight of 3.5 pounds, but a decrease of 0.2 kg/m2 (0.4 pounds) for BMI.
Dr. Swanson noted, "Although there were fluctuations in growth parameters with the MPH patch, they appeared to be minimal deficits at the end of 12 months."
Again, it's important to note that though the two studies showed different outcomes- one using a short acting Methylphenidate; the other a long acting Methylphenidate patch, more studies are needed long term to assess the final growth outcome in children treated for ADHD.
SOURCES: Swanson, J.M. Journal of the American Academy of Child and Adolescent Psychiatry, August 2007; vol 46: pp 1014-1026.
Effects of Methylphenidate Transdermal System (MTS) on Growth in Children With ADHD. NR6-027: Presented at APA, May 2008
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