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. 2018 May 10;2018(5):CD012069. doi: 10.1002/14651858.CD012069.pub2

Poulton 2003.

Methods A retrospective cohort study of growth data
Participants Number of participants screened: not stated
Number of participants included: 19
Number of participants followed up: 6 months: 19, 18 months: 13, 30 months: 6, 42 months: 4
Number of withdrawals: 6 months: 0, 18 months: 6, 30 months: 13, 42 months: 15
Diagnosis of ADHD: DSM‐IV (subtype: not stated)
Age: range 3.1‐11.4 years old
IQ: > 70
Sex: 17 males, 2 females
Methylphenidate‐naïve: 100%
Ethnicity: not stated
Country: Australia
Comorbidity: not stated
Comedication: clonidine
Sociodemographics: not stated
Inclusion criteria
  1. ADHD diagnosis according to DSM‐IV

  2. Patients from a single private practice in Penrith prescribed methylphenidate in 1999


Exclusion criteria
  1. Methylphenidate for less than 6 months

  2. Previous experience with stimulant treatment

Interventions Methylphenidate type: not stated
Methylphenidate dosage: 10‐40 mg/day
Mean methylphenidate dosage: 1.0 (SD 0.24) mg/kg per day, median 27.5 mg
Administration schedule: not stated
Duration of intervention: 6‐42 months
Treatment compliance: many patients were taking less than the prescribed dose of stimulant medication, ceasing or reducing medication at weekends or during school holidays, but precise details were not available
Outcomes Non‐serious adverse events:
  • Height ‐ measured to the nearest 1 mm by the same observer using a wall‐mounted stadiometer, measured every 6th month or more frequently if clinically indicated

  • Weight ‐ measured to the nearest 0.5 kg using electronic scales, measured every 6th month or more frequently if clinically indicated


Both measures without shoes and outdoor clothing
Notes Sample calculation: no
 Ethics approval: no
 Funding/vested interest: none
Key conclusions of the study authors: stimulant medication is associated with a decrease in height and weight SD scores during the first 6‐30 months with a characteristic pattern on the growth chart
Comments from the study authors: all children were started on dexamphetamine initially but were changed on to methylphenidate if the response was suboptimal or they experienced adverse effects. When weight loss occurred the parents were asked to reduce or omit the medication whenever possible and to encourage the child to eat more
Exclusion of methylphenidate non‐responders/children who have previously experienced adverse events on methylphenidate: no
Supplemental information regarding data received through personal email correspondence with the authors in November 2013 (Poulton 2013 [pers comm])