A significant difference in bone mineral density (BMD)  was noted in patients aged 8–17 who have used attention deficit hyperactivity disorder (ADHD) medication, compared to their same aged counterparts who have not taken the medication. The findings come from a new study published in the Journal of Pediatric Orthopedics, which tested 3 regions of BMD: total femur, femoral neck, and lumbar.

Study authors used data from 3 waves of National Health Nutrition Examination Surveys (NHANES), collected from 2005 through 2010 to reach their findings. The survey included 5,315 individual records; the matched sub-sample included 1,967 children and adolescents. Use of ADHD medications in these records was self-reported.

The results from each one of the outcomes indicated that standardized BMD measures for the ADHD medication use group were significantly lower; estimates ranged from -0.4855 (P<0.001) for total femoral, -0.4671 (P<0.001) for femoral neck, and -0.3947 (P<0.01) for lumbar, compared to non-medications group. Additionally, significantly more children on ADHD medications vs. match subjects on no medication had BMDs within the osteopenic range (38.3% vs. 21.6%, P<0.01).

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These findings are consistent with previous data that ADHD medications may be tied to negative BMD differences. The authors hypothesize that the effects on BMD in ADHD medication use groups is due to their propensity for placing children in lower weight for age categories. Side effects of these medications are known to alter dietary intake of calcium.

The recommended daily intake is 1300mg/day of calcium and 600 IU/day of vitamin D. Children on ADHD medications tend to have lower caloric intake compared with non-medicated counterparts, placing micronutrient and macronutrient intake at risk.

“We believe this has important implications for the long-term bone health in patients with ADHD because childhood and adolescence is the period of life for bone mass accrual,” concluded the authors.

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