ADHD Medications May Threaten Bone Health in Kids

A new study finds that children taking ADHD meds may have a higher risk for weak bone mass that may develop into osteoporosis.
ADHD News Feed | posted by Devon Frye

Children on ADHD medications show “real and nontrivial” differences in bone health compared to children not on ADHD medications, suggests a new study. The finding alarms researchers who want further study on the long-term effects these medications may have on children’s developing bones.

The study, presented on March 3 at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS), used data from the CDC's National Health and Nutrition Examination Survey to compare bone health in more than 5000 children, some of who reported taking medications for ADHD (both stimulants and non-stimulants).

The results were shocking: Approximately 25 percent of the children on ADHD medications had signs of osteopenia, a condition characterized by weak bone mass that can develop into osteoporosis. Children on ADHD medications also showed lower bone mineral density in the femur, femoral neck and lumbar spine — key areas for assessing overall bone health.

The study is the first to show a link between ADHD medications and bone health, and researchers note that there is not yet definitive proof that ADHD medications directly cause problems with bone health.

The researchers hypothesized several theories for the link. One is the fact that ADHD medications reduce appetite, which may result in poor nutrition — particularly in a young child. This may lead to weaker bones and symptoms of osteopenia. Another is the fact that ADHD medications interact with the sympathetic nervous system, which is responsible for bone regeneration and remodeling. This may mean that the link between ADHD medications and bone health could be direct and, perhaps, causal. At this point, researchers say, there’s no way to know for sure.

"I'm in no way saying that kids shouldn't be on these medications," said Dr. Jessica Rivera, the senior researcher on the study. But, she continued, "this is an important step in understanding a medication class, which is used with increasing frequency, and its effect on children who are at a critical time for building their bones.”

When asked if children should get bone scans before and after ADHD medication is prescribed, Rivera said no. "I think that our findings are too early to suggest a change in practice," she said. "What would be needed is a prospective study on children's bone health who are on ADHD medications.

“However,” she added, “what I do believe our study allows is a good opportunity for clinicians and parents alike to make sure they are discussing their patients' and children's nutritional needs."


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