In 2007, the preliminary results from a study that had begun eight years earlier were announced. A group of seven-year-olds diagnosed with ADHD were split into two groups. One half was treated with Ritalin for the next three years, and others received no treatment for their condition. The results were clear to researchers — the group treated with ADHD medication ended up around 1 inch shorter than their peers who didn’t receive treatment. Essentially, stunted growth is one of the permanent effects of Adderall, or so it would seem. Further studies have concluded there is no long-term correlation between stimulant use and final adult height.
These conflicting views are considered along with previous research that seemed to conclude that these medications had no effect on the development of young children, raising an important question: What are the permanent effects of Adderall, Ritalin, Vyvanse and other “focus drugs”?
In this piece, we’ll look at some of the research that’s been done on the subject and attempt to assess the risk that prescription amphetamine use presents to the millions of kids worldwide who rely on these drugs to stay focused.
The Permanent Effects of Adderall: A Quick Look at the Stakes
ADHD is an extremely common diagnosis worldwide. In 2016, it was estimated that 6.1 million children were diagnosed with the condition. At the same time, so-called “focus drugs” are the primary means of treatment within the population of kids who suffer from an attention disorder. With so many children using stimulants over a long period of time to control their symptoms, it’s critically important to understand the long-term risks.
But, at present, research isn’t conclusive. The results of the study mentioned at the beginning of this piece — the one that suggested that amphetamines do stunt kids’ growth — were published in 2007. This refuted a previous, widely accepted opinion of a National Institutes of Health panel that these drugs absolutely didn’t affect healthy growth and development. In 2010, research appearing in Canadian Family Physician concluded that ADHD meds “might” affect growth. An empirical review of historical data conducted by the American Academy of Pediatrics in 2014 brought back the assessment that these drugs had no effect on the growth of their users.
We could go on, but the point is clear. There’s just no professional agreement on potential permanent effects of Adderall and similar drugs.
Why Might Amphetamines Stunt Growth?
With the caveat that there’s simply not a large enough body of research to conclude that amphetamines do or don’t stunt growth, let’s take a look at the science. The inconclusive 2010 study in Canadian Family Physician summarized three mechanisms through which these focus aids may stunt growth.
The first is an indirect factor. Amphetamines — and stimulants in general — tend to reduce the appetite of the person who uses them. This is actually something that pediatricians warn parents about before prescribing these drugs, but still, children with ADHD may not be getting the same nutrition as their peers if they’re taking Adderall or Ritalin. Malnutrition is a factor that definitely affects growth.
The second potential reason points to a dopamine imbalance. Amphetamines prompt the release of dopamine, a chemical that produces feelings of euphoria. According to some research, there’s evidence that points to the resulting hormone imbalance having a negative effect on the human growth rate.
The final potential cause for stunted growth concerns all stimulants, including caffeine. Some studies suggest that stimulants restrict the healthy growth of cartilage, which affects overall growth and development.
Do These Effects Apply to Other Focus Aids?
Without the research to say for sure, it would be safe to say that if any of these pathways are causing one ADHD medication to stunt growth, it would apply to all drugs of this class. That means, for example, that the long-term effects of Vyvanse would at least be similar to the long-term effects of Adderall and so forth.
Are These Effects Reversible?
One of the issues with trying to figure out any drug’s effect on patients in different age groups is that ADHD is essentially in a class of its own. There are very few other conditions that are as common as ADHD, especially in children. That means that until we have a sufficient body of research with which to make concrete judgments, there are going to be many questions that are impossible to answer about this class of drugs. However, the research announced in 2007 suggests that, since results were measured over the long-term, the effects are not reversible.
Other Known Health Risks of ADHD Medications
The possibility of effects on health growth is one reason to be wary about taking Adderall for an extended period of time. There are other health risks associated with focus drugs as well. The possibility of dependence and addiction is one. The majority of people who take Adderall or Ritalin as prescribed don’t experience ill effects, but dependence can set in, dulling the effectiveness of the drug over time.
Another concern with Adderall is a link with a condition called amphetamine psychosis, which is similar to the side effects of abusing methamphetamine. People who abuse focus drugs or use a high dosage for a long period of time can experience intense hallucinations and lose their grip on reality. These cases are typically acute, clearing up once the drug is out of the user’s system, but in some cases, long-term use and abuse of Adderall can cause existing mental health conditions to worsen.
Amphetamine psychosis is a key sign of Adderall neurotoxicity. These cases tend to occur in adults — the most likely population to abuse Adderall or to use it in high enough doses to cause ill effects over the long term.
Are There Alternatives to Adderall, Ritalin and Vyvanse?
Amphetamines prescribed to treat ADHD are stimulants. These are the drugs with the potential to stunt growth in addition to the other side effects discussed. Some patients have had success with non-stimulants and antidepressants, but not much is known about the long-term effects of these classes of drugs in children.
Parents looking for safer alternatives may opt to try treatments that don’t involve medication at all. Sometimes, lifestyle changes, improved nutrition and sleep can have a positive effect on focus. In most cases, the most effective alternative to medication is behavioral therapy.
If you’re an adult patient looking for the safest way to treat your ADHD, the team at FHE Health understands your concern about potential health risks and permanent effects of Adderall and similar substances. Contact us today and learn more about your options.