- Anorexia, abdominal discomfort, insomnia and weight loss are side effects that are common to these medications but appear to resolve in most patients with continued therapy.
- Potential growth suppression has been a concern. Patients may show a temporary decrease in linear growth and weight gain however there is no evidence that these medications affect ultimate adult stature or weight (38-39).
- Stimulant medications are now considered safe in children with seizure disorders if the child's seizures are well controlled on a single anticonvulsant (40).
- Cardiovascular Effects: Dextroamphetamine and methylphenidate have sympathicomimetic effects and may elevate blood pressure and heart rate. Clonidine may lower blood pressure or cause rebound hypertension if stopped rapidly(41).
- The risk of unmasking or exacerbating a tic disorder with methylphenidate, dextroamphetamine and pemoline is only 1.3% (42). This risk could be higher if there is a family history of a tic disorder. Clonidine is the preferred initial medication for children with tics because it suppresses tic disorders (43). The presence of or family history of a tic disorder is not an absolute contraindication to the stimulants but the patient should be monitored closely for exacerbation of tics. This effect is reversible with discontinuation of the drug.
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