Growth Monitoring on Psychotropic Medication
Psychotropic medications are often associated with changes in appetite. This may be because brain centers involved with motivation and reward influence both appetite and behavior. For example, stimulant medications enhance the effect of dopamine on the striatal dopamine D2 receptors and suppress the appetite. Antipsychotics are associated with obesity, binding with the D2 receptors so that fewer are available for activation by dopamine. For both classes of drug the effects on appetite often seem to correlate with the therapeutic effects, suggesting a closely related mechanisms or even a common pathway for aspects of behavior and appetite. Changes in appetite lead to changes in the rate of weight gain with secondary effects on the rate of growth in height. Changes in the rate of physical development would also be anticipated. If medication is continued, the rate of weight gain normalizes and a new equilibrium of normal growth rate for height and weight is reached. This takes about 3 years for stimulant medication. In the treatment of ADHD it is important to adjust the dose of stimulant medication to get an optimal therapeutic response. Titrating the dose to the therapeutic response ensures that stimulant toxicity is uncommon and addiction and psychosis extremely rare. The correlation between appetite suppression and a therapeutic response can be helpful as an additional guide for dosage adjustment. This correlation could also be applied to the use of stimulant medication in the treatment of obesity because the dose could be adjusted according to behavioral outcomes rather than continually being raised to increase the weight loss.
KeywordsAttention Deficit Hyperactivity Disorder Psychotropic Medication Antipsychotic Medication Stimulant Medication Pubertal Development
Attention deficit hyperactivity disorder
Body mass index
Centers for Disease Control and Prevention
Dopamine receptor subtype 2