The effects of stimulants on eating patterns in children and adolescents with Attention Deficit Hyperactivity Disorder

Journal of Mind and Medical Sciences Volume 6 | Issue 2 Article 12 2019 The effects of stimulants on eating patterns in children and adolescents with Attention Deficit Hyperactivity Disorder Serkan Turan Aynur Pekcanlar Akay Follow this and additional works at: https://scholar.valpo.edu/jmms Part of the Mental and Social Health Commons, Preventive Medicine Commons, Primary Care Commons, and the Psychiatry Commons Recommended Citation Turan, Serkan and Akay, Aynur Pekcanlar (2019) "The effects of stimulants on eating patterns in children and adolescents with Attention Deficit Hyperactivity Disorder," Journal of Mind and Medical Sciences: Vol. 6 : Iss. 2 , Article 12. DOI: 10.22543/7674.62.P253260 Available at: https://scholar.valpo.edu/jmms/vol6/iss2/12 This Research Article is brought to you for free and open access by ValpoScholar. It has been accepted for inclusion in Journal of Mind and Medical Sciences by an authorized administrator of ValpoScholar. For more information, please contact a ValpoScholar staff member at . https://scholar.valpo.edu/jmms/ https://proscholar.org/jmms/ ISSN: 2392-7674 J Mind Med Sci. 2019; 6(2): 253-260 doi: 10.22543/7674.62.P253260 Received for publication: August 02, 2019 Accepted: September 17, 2019 Research article The effects of stimulants on eating patterns in children and adolescents with Attention Deficit Hyperactivity Disorder Serkan Turan1, Aynur Pekcanlar Akay2 MD. Consultant Child Psychiatrist, Department of Child and Adolescent Psychiatry, Ödemiş State Hospital, Izmir, Turkey 2 MD. Professor, Department of Child and Adolescent Psychiatry, Dokuz Eylül University Medical Faculty, Izmir, Turkey 1 Abstract Objectives. This study aims to evaluate the effects of methylphenidate (MPH) on eating patterns and body mass index (BMI) in children with attention deficit/hyperactivity disorder (ADHD). The secondary aim of this study is the comparison between weight and eating behavior of children with ADHD undergoing an MPH treatment, and of children without ADHD. Methods. One hundred fourty three children and adolescents who diagnosed with ADHD were enrolled, and the effects of MPH on the eating patterns and BMI were evaluated. All participants completed a number of tests to analyze eating patterns and clinical psychopathological profiles. Results. Children and adolescents with ADHD had significantly higher scores on the EDE-Qeating concern, EDE-Q- shape concern, and all CPRS-RSF subscales than individuals without ADHD (p < .05). MPH treatment was associated with a notional reduction in height-sds and weight-sds. The results of the correlation analysis which assessed the possible contribution of the different treatment-related factors revealed no significant correlations between MPH mean dose [mg/(kg/d)], the duration of use (months), and the core characteristics of eating disorders except the restraint subscale of EDE Q. Conclusions. Our findings add to the growing research suggesting that MPH may be associated with disordered eating behaviors. Although the literature is limited, our findings conclude that MPH may not be associated with the reduction of growth velocity and disordered eating behaviors. Keywords  Highlights ✓ Patients with ADHD have significantly higher scores from the EDE-Q- eating concern, EDE-Q- shape concern and all CPRS-RSF subscales than individuals without ADHD. Methylphenidate, eating patterns, height, weight, BMI ✓ EDE-Q shape concern and CPRS-RSF subscale scores seem to be correlated with inattention and cognitive problems. To cite this article: Turan S, Akay AP. The effects of stimulants on eating patterns in children and adolescents with Attention Deficit Hyperactivity Disorder. J Mind Med Sci. 2019; 6(2): 253260. DOI: 10.22543/7674.62.P253260 *Corresponding author: Serkan Turan, Ödemiş State Hospital Department of Child and Adolescent Psychiatry, Post code: 35750, Izmir, Turkey E-mail: Serkan Turan & Aynur Akay Introduction Materials and Methods Attention Deficit Hyperactivity Disorder (ADHD) is defined as a neurodevelopmental disorder that reflects the persistence of ADHD symptoms such as inattention, overactivity, and impulsivity across the lifespan (1). Children with ADHD are at elevated risk of comorbid psychopathology such as mood disorders, anxiety disorders, substance use disorders, learning disorders, and conduct disorders (2). Some studies also suggest a possible link between ADHD and an increased risk of eating disorders, specifically that eating disorders and ADHD may share common clinical features and that ADHD rates may increase eating disorders and/or contribute to the seriousness of pathological eating behaviors (3). Biederman et al. (2010) reported that girls treated for ADHD in childhood and adolescence were 3.5 times more likely to be diagnosed with eating disorders than girls without ADHD in young adulthood (95% CI: 1.6-7.3) (4). Similarly, Yoshimasu et al. found that children with ADHD were 5.7 times more likely to have eating disorders than those without ADHD (95% CI: 1.1-28.2) in late adolescence, based on data from a population-based birth cohort (5). Childhood ADHD symptoms have been associated with the development of irregular eating behaviors including bulimic symptoms, binge eating, and restrictive eating in the present and subsequent period (6, 7). However, in ADHD studies with both subjective and objective eating disorder examination instruments, consistent results are lacking, although it should be noted that the effects of long-term methylphenidate (MPH) on both appetite and weight have been minimally studied. A recently published, double-blind, drug-placebo, cross-over design trial found improvements, using MPH compared to placebo, in rates of binge eating cessation (8). Decreased appetite is the most frequent adverse effect of stimulants, but it is not necessarily related to a decrease in height and BMI. The association between stimulants and a delay in growth is still unclear and controversial. Although a recent review and meta-analysis reported the prevalence of obesity in children/adolescents with ADHD is 40% higher than in healthy children/adolescents, a notable side effect of MPH is thought to be growth delay (9). This study evaluated the effects of MPH on eating patterns in Turkish children and adolescents with ADHD and also in healthy controls. The secondary aim of this study was the comparison of weight and eating behavior patterns between children with ADHD and MPH treatment and children without ADHD. In this context, we hypothesized that (I) MPH and ADHD would show a negative effect on eating patterns, and (II) would be associated with reduction of height, weight, and body mass index (BMI) in Turkish children and adolescents. Study setting and subjects We reviewed the medical records of 152 children and adolescents (aged 6-18 years) with ADHD who received treatment with MPH for at least 1 year at the Department of Child and Adolescent Psych (...truncated)