Introduction: Several medications used to treat attention deficit hyperactivity disorder (ADHD) have been associated with diminished bone mineral density (BMD) in children. The objective of this study was to determine if evidence exists for a similar association among adults.
Materials and methods: A retrospective cross-sectional analysis was conducted using data collected by the National Health Nutrition Examination Survey 2013-2018. Data from 7961 individuals aged 18 to 50, 79 of whom were taking medications to treat ADHD. Dual-energy X-ray absorptiometry scans provided measure of body composition. Linear regression models were used to examine associations between ADHD medication use and body composition.
Results: Stimulant ADHD medication usage was found to be associated with decreased BMD in both the skull (-6.6%; 95% CI 5.9-7.2) (P < 0.05) and thoracic spine (-6.0%; 95% CI 5.1-7.0) (P < 0.05). No difference in BMD was seen in any other skeletal region based on stimulant ADHD medication use (P > 0.05). We found no evidence to suggest that duration of use affected the observed decreases in BMD, P > 0.05.
Conclusion: This study using a nationally representative sample assessed whether stimulant medication use in adults with ADHD was associated with decreased BMD. The overall results are inconclusive. Further study is needed to better evaluate if ADHD and/or stimulant medication use is independently associated with bone health.
Keywords: ADHD, attention deficit hyperactivity disorder; APA, American Psychiatric Association; Attention deficit hyperactivity disorder (ADHD); BMC, bone mineral content; BMD, bone mineral density; Bone; Bone mineral density; CDC, Centers for Disease Control and Prevention; CI, confidence interval; DXA, dual energy X-ray absorptiometry; Dual energy X-ray absorptiometry (DXA); ETS, environmental tobacco exposure; GLMs, general linear models; MEC, mobile examination center; NHANES, National Health and Nutrition Examination Survey; Stimulant mediation.
Published by Elsevier Inc.