DOESMETHYLPHENIDATESTIMULANTMEDICATIONORAMPHETAMINESTIMULANTMEDICATIONHAVEAHIGHERPREVALENCEOFINSOMNIA,LOSS

OFAPPETITE,ORWEIGHTLOSSINPEDIATRICADHDPATIENTS?ColinMacKichan1,DrLaurieScheiner2,KeilaVeiga2,andLauraGruessner2

1TrinityCollege,Har1ord,CT,2Connec5cutChildren’sMedicalCenter,Har1ord,CT

MATERIALS AND METHODS

This retrospective study bases its data on a previous study that asked parents to fill out pre-visit questionnaires about 17 different symptoms and side effects associated with ADHD and ADHD medication. The sample size if the study was 114, but only 24 cases were used. Patients were used •  between the age of 4 and 16 •  with a year or less since medication initiation •  using methylphenidate or amphetamine medication

The final sample size consisted of eight male and one female participant between the ages of 5 and 14 for amphetamine stimulants, and nine male and six female users between the ages of five and eleven for methylphenidate stimulants.

Responses were recorded in “yes or no” fashion, and compared in relation to the participant’s medication type, gender, and dosage. The responses were then logged into Microsoft Excel and percentages of each side effect was determined for both methylphenidate and amphetamine stimulants. These results were then analyzed using a two sample T-test with equal variance.

INTRODUCTION

Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder of childhood (AAP, 2011). Four major roadblocks stand in the way of proper ADHD treatment (AAP, 2011). 1.  Primary care doctors are given limited payment for what is a timely

and expensive treatment. 2.  ADHD treatment requires a large time commitment by parents,

teachers, and patients, which in some cases can be unattainable. 3.  Mental health clinicians are relatively limited in their ability to

address the problem, so care and cooperation from multiple specialty physicians is needed.

4.  Insurance companies and third party payers do not consider ADHD a health related problem, which leaves many patients left to pay for their treatment out of pocket. (AAP, 2011) Methylphenidate stimulant medication and amphetamine stimulant

medication are today’s solutions to these issues. •  Methylphenidate works on dopaminergic and noradrenergic system,

mostly focusing on the prefrontal cortex, creating better cognition, attention, and working memory (Pruessner, 2008).

•  Amphetamine stimulants have been shown to work on the dopaminergic system, more specifically in the mesolimbic system, the caudate nucleus, and the lateral thalamus (axon.psyc.memphis.edu)

These two medications are known to have three main side effects, weight loss, trouble falling asleep, and decreased appetite. In this particular retrospective cohort study, the question will be if methylphenidate stimulants or amphetamine stimulants will lead to higher levels of appetite loss, trouble falling asleep, or weight loss. It is predicted that both medications will have the same level of side effects.

CONCLUSIONS 1. No difference in weight loss, loss of appetite, and trouble falling asleep in comparison between

amphetamine stimulant medication and methylphenidate stimulant medication use, gender, or dosage 2. Loss of appetite was reported about 27% of the time for both medication types, yet weight loss was

less than 10%, implying the effects of any appetite loss were negligible 3. Trouble falling asleep was reported most often, which may impact growth. However, this study

increased credibility to former studies which found loss of growth to exist, which found its effect negligible

DISCUSSION

It was hypothesized that the two stimulants would have equal occurrences of all three side effects, and the results of this study supported this hypothesis. It was found that both methylphenidate and amphetamine stimulants had about the same percentages of reported cases for loss of appetite and weight loss. There was a larger difference between the two populations for trouble falling asleep, but the difference was not statistically significant. It was also found that dosage and gender did not have an effect on the prevalence on the three side effects.

The most prevalent side effect was found to be trouble falling asleep in all three groups. Although this number is high, it is very possible that users experienced issues initially falling asleep, but the quality of their sleep remained unaffected. A loss of sleep would most likely most impact loss of growth in children, but these statistics were not reported. However, this study was able to lend further credibility to former studies, which had concluded that loss of growth was negligible ot transient, disappearing after the first year. The second most prevalent side effect was found to be loss of appetite. It can be assumed that a loss of appetite would lead to weight loss, but it was found that weight loss was reported the least often of the three side effects. These findings lead to the conclusion any loss of appetite experienced was negligible in its effects on weight loss.

Since previous studies both medications were reported to have insomnia, weight loss, and loss of appetite as their main side effects, it is then of no surprise that the prevalence of each side effect was also similar between the two stimulant types. This study builds on previous experiments that examined the side effects associated with each, but makes novel conclusions by directly comparing the prevalence of each side effect in regards to stimulant type.

To further establish the findings of this study, future experiments should attain lager sample sizes. Future experiments should also base their measurements off both parental and patient questionnaires. It is very possible that parent’s may be unaware of their child’s trouble sleeping or loss of appetite, and by directly asking the patient the reliability of the conclusions that be raised.

RESULTS

SOURCES

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Figure 1: Percentage of Weight Loss, Loss of Appetite, and Trouble Falling Asleep in Respect to Medication Type

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Figure 3: Percentage of Weight Loss, Loss of Appetite, and Trouble Falling Asleep in Respect to Gender

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RaisedDosage BaseDosageFigure 2: Percentage of Weight Loss, Loss of Appetite, and Trouble Falling Asleep in Respect to Dosage