ADHD Drug Side Effects May Lower Bone Density: Study

The findings of new research suggest that children who receive popular medication for attention deficit hyperactivity disorder (ADHD), such as Ritalin or Adderall, may face a risk of having lower bone density, putting them at risk later in life. 

According to a press release issued by the Endocrine Society on April 3, researchers have found that bone density was lower among children who used ADHD medications. The study was presented at the Endocrine Society’s 98th annual meeting in Boston. The findings are considered preliminary, as the research has not been published in a peer-reviewed medical journal.

ADHD affects more than 6 million children in the U.S., according to estimates by the U.S. Centers for Disease Control and Prevention (CDC). While drugs used to treat the condition are generally considered safe, a number of potential health concerns have been linked to side effects of ADHD drugs, including the potential for cardiovascular events.

If the findings regarding bone density problems with ADHD drugs are confirmed, a large population of youth may be at risk as they get older, following years of use.

Alexis Feuer, MD, a pediatric endocrinologist at Weill Cornell Medicine in New York City, and a team of researchers studied bone density in nearly 6,500 youth, ages eight to 20, who participated in the National Health and Nutrition Examination Survey (NHANES), a survey the CDC conducts to assess the health of U.S. adults and children.

Survey data from 2005 and 2010 was analyzed for youth who had bone density scans. The scans evaluated bone mineral content, the weight of the bone, which is often a better measurement for children; as well as bone mineral density, a measurement that helps determine bone strength.

A total of 159 children and teens used stimulants, such as Concerta or Ritalin, methylphenidate-containing drugs, or medications like Adderall that contain methamphetamine, compared to 6,330 children who did not.

Among users of ADHD medications like Ritalin, the average bone mineral content at the lumbar spine was 5.1 percent lower and 5.3 percent lower at the hip than nonusers of ADHD meds.

As for bone density, users of Ritalin and Adderall had 3.9 percent lower in measurements at the spine and 3.7 percent lower at the hip compared with nonusers of the medications.

“Adolescence and young adulthood are critically important times for accruing peak bone mass—the largest and densest bone,” Feuer said. “Failure to obtain adequate bone mass by early adulthood may result in an increased fracture risk or even the development of osteoporosis later in adulthood.”

Researchers emphasized this does not prove medications like Ritalin and Adderall cause lower bone density. Instead, they say more studies are needed that evaluate the levels of bone density and bone mineral content at more than one point in time.