目的：使用兴奋剂产品治疗注意力缺陷/多动障碍（ADHD）已被证明是安全有效的；但是，人们仍然担心它们对增长轨迹可能产生的不利影响。我们对来自生态有效数据库和注册表的现有文献进行了系统回顾，以评估有关兴奋剂对自然样本生长轨迹影响的知识体系。方法：使用PubMed和PsycINFO，我们从来自自然人群研究的综合数据集中,搜索了2023年2月8日之前发表的文章,这些文章关注儿科ADHD中与兴奋剂治疗相关的生长结果.结果：在最初确定的1070篇文章中，12符合所有纳入标准。样本量从157到163,820名青年不等。检查身高的10篇文章中有7篇发现，与慢性兴奋剂治疗相关的身高显着下降，在2项研究中，随着时间的推移而恢复正常。三篇文章发现兴奋剂治疗与身高之间没有显着关联。在兴奋剂治疗的累积持续时间和剂量与成人身高之间没有明确的关联。所有检查体重的文章和检查体重指数（BMI）的八篇文章中的六篇发现，最初的显着下降趋于正常化，然后随着时间的推移而增加。延长使用兴奋剂药物的持续时间主要与体重和BMI的显着降低有关。兴奋剂剂量对体重和BMI的影响大多较弱，临床上不明显。大多数研究发现兴奋剂治疗开始时的年龄与身高变化之间没有显着关联，体重,或BMI。大多数研究没有发现与生长参数相关的显著性别效应。结论：对生态信息样本的审查表明，兴奋剂治疗对生长轨迹的影响主要是小而短暂的。对于大多数从儿童到青春期和成年期接受兴奋剂治疗的ADHD年轻人来说，这些影响似乎在临床上微不足道。
Objective: Attention-deficit/hyperactivity disorder (ADHD) treatment with stimulant products has been shown to be safe and effective; however, there are remaining concerns about their possible adverse effects on growth trajectories. We conducted a systematic
review of the extant literature derived from ecologically valid databases and registries to assess the body of knowledge about the effects of stimulants on growth trajectories in naturalistic samples. Methods: Using PubMed and PsycINFO, we searched for articles published before February 8, 2023 that focused on growth findings associated with stimulant treatment in pediatric ADHD from comprehensive datasets derived from naturalistic population studies. Results: Of the 1070 articles initially identified, 12 met all inclusion criteria. Sample sizes ranged from 157 to 163,820 youths. Seven of 10 articles examining height found significant decreases in height associated with chronic stimulant treatment that normalized over time in 2 studies. Three articles found no significant association between stimulant treatment and height. No clear associations were identified between cumulative duration and dose of stimulant treatment and adult height. All articles examining weight and six of eight articles examining body mass index (BMI) found significant initial decreases that tended to normalize then increase over time. Longer duration of stimulant medication use was predominantly associated with significant weight and BMI reductions. The effects of stimulant dose on weight and BMI were mostly weak and clinically insignificant. Most studies found no significant association between age at start of stimulant treatment and change in height, weight, or BMI. Most studies did not find significant sex effects in relation to growth parameters. Conclusions: This
review of ecologically informative samples revealed that the effects of stimulant treatment on growth trajectories are mainly small and transient. These effects seem to be clinically insignificant for most youth with ADHD who receive stimulant treatment from childhood onto adolescence and adulthood.
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