do adhd stimulants like amphetamine slow children's growth and affect sleep?
“it's remarkable but they're worried about the reduced uh growth effects.”
a host said on Huberman Lab, 2026-09-21, at 2:14:53. hear it in context →
first, the part that holds
both halves of the claim hold up. the current fda label for an extended-release amphetamine product says stimulants slow growth in children and lists insomnia as one of the most common side effects. the largest long-term study we found ties years of stimulant use to shorter adult height.
what we found when we went and looked
we read the current fda prescribing information for an extended-release mixed amphetamine salts product (revised 04/2026). it has a warning section titled "long-term suppression of growth in pediatric patients," which says cns stimulants "have been associated with weight loss and slowing of growth rate" and that "chronic use of amphetamines can be expected to cause a similar suppression of growth." in the same label's 3-week trial in children aged 6 to 12, 17% on the drug reported insomnia against 2% on placebo. in the mta follow-up into young adulthood, children who kept taking stimulants through adolescence (consistently or on and off) ended up 2.55 cm shorter than those who barely took them (p<0.0005). that comparison was observational, and most of the stimulant in it was methylphenidate, not amphetamine. a cochrane review of amphetamines in children, which we read as summarized in a published review of cochrane reviews, found about 3.8 times the risk of sleep problems compared with placebo.
assertion by assertion
| assertion | verdict | what the record says |
|---|---|---|
| adhd stimulant medications such as amphetamine reduce growth in children | confirmed | the fda label (section 5.5) says cns stimulants are associated with weight loss and slowing of growth rate in children, and that chronic amphetamine use "can be expected to cause a similar suppression of growth." it tells prescribers to monitor height and weight, and says children who are not growing as expected may need treatment interrupted. the label's controlled data on this point are short-term weight loss in adolescents during the first 4 weeks: -1.1 lb at 10 mg and -2.8 lb at 20 mg. it gives no height figure from randomized trials. the speaker gave no size for the effect, and the direction matches the label. [1] |
| adhd stimulant medications such as amphetamine also affect sleep | confirmed | label table 1 (children 6 to 12, 3-week trial): insomnia in 17% on drug vs 2% on placebo. table 2 (adolescents): 12% vs 4%. insomnia was also the most frequent drug-related reason adolescents stopped treatment in the trial (1.3%). the label says afternoon doses should be avoided "because of the potential for insomnia." the cochrane amphetamine review, as summarized in a review of cochrane reviews, reports sleep problems at rr 3.80 (95% ci 2.12 to 6.83), with very low to low quality evidence from trials averaging 28 days. [1][3] |
| the growth effect lasts into adult height (context for why people are worried) | confirmed | mta follow-up: participants who used stimulants consistently or inconsistently were 2.55 ± 0.73 cm shorter as adults than those with negligible use (p<0.0005, d=0.42). consistent users were 2.35 ± 1.13 cm shorter than inconsistent users (p<0.04). after the first 14 months, medication use was not randomized, and most of it was immediate-release methylphenidate, with other stimulants converted to methylphenidate-equivalent doses. so this supports a lasting height effect for stimulants as a class, not amphetamine specifically, and it shows an association rather than proven cause. [2] |
| popular framing: stimulants stunt children's growth dramatically | overstated | the best long-term figure we read is about 2.5 cm (roughly an inch) of adult height, comparing heavy users with near-non-users. that is a real difference, but a modest one (d=0.42), and it comes from an observational comparison. the same study found the adhd group as a whole was 1.29 cm shorter than local non-adhd peers, so not all of the gap can be cleanly pinned on the medication. [2] |
both directions
for the speaker: the fda label gives growth suppression its own warning section, says chronic amphetamine use can be expected to suppress growth, and requires height and weight monitoring. insomnia ran at 17% vs 2% on placebo in children and 12% vs 4% in adolescents. the mta follow-up linked sustained stimulant use from childhood through adolescence with about 2.5 cm less adult height, and found more consistent use went with a larger deficit (a dose-response pattern). the cochrane amphetamine review found sleep problems about 3.8 times as often as on placebo.
against: nothing we read contradicts either clause. what cuts against the stronger reading is that the evidence is thinner than the label's certainty suggests. the label's own controlled growth data are 4-week weight changes, not height. the long-term height data come mostly from methylphenidate users, and medication use was self-selected rather than randomized. the adhd group was already shorter than its non-adhd peers, which points to some confounding. the size of the adult effect is modest, about 2.5 cm. the cochrane sleep finding rests on very low to low quality evidence from trials averaging only 28 days, so it says little about whether sleep problems persist over months or years.
what this cannot say
no randomized trial has followed amphetamine-treated children to adult height, and the mta height result is an observational association, mostly involving methylphenidate. the label's insomnia rates come from trials of 3 to 4 weeks that relied on reported side effects rather than measured sleep. we did not read the cochrane amphetamine review itself (the publisher blocked access). its sleep figures come from a peer-reviewed review of cochrane reviews. we also could not load an objective-sleep meta-analysis in pediatrics, so we do not cite it. the quote does not say who "they" are, so we cannot check who is worried. we judged the clauses as written, and the speaker gave no size for either effect.
sources, each one fetched and read
- us food and drug administration, prescribing information for mixed salts of a single-entity amphetamine product extended-release capsules (nda 021303), revised 04/2026 What we read there: section 5.5: "cns stimulants have been associated with weight loss and slowing of growth rate in pediatric patients... chronic use of amphetamines can be expected to cause a similar suppression of growth." table 1 (children 6-12): insomnia 17% drug vs 2% placebo. table 2 (adolescents): insomnia 12% vs 4%. section 2.2: "afternoon doses should be avoided because of the potential for insomnia." Fetched 2026-10-20 (HTTP 200). https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/021303s040lbl.pdf
- mta cooperative group investigators, "young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy and height suppression," journal of child psychology and psychiatry, 2017;58(6):663-678 What we read there: "the treated group with the consistent or inconsistent pattern was 2.55+0.73 cm shorter than the subgroup with the negligible pattern (p<0.0005, d=0.42)." conclusion: "extended use of stimulant medication from childhood through adolescence is associated with suppression of adult height but is not associated with reduced symptom-severity in adulthood." Fetched 2026-10-20 (HTTP 200). https://pmc.ncbi.nlm.nih.gov/articles/PMC6168061/
- "a review of cochrane reviews on pharmacological treatment for attention deficit hyperactivity disorder," dementia & neuropsychologia, 2021 What we read there: summarizing the 2016 cochrane review of amphetamines for adhd in children and adolescents: sleep problems rr 3.80 (95% ci 2.12-6.83), decreased appetite rr 6.31 (95% ci 2.58-15.46), evidence quality very low to low, mean trial duration 28 days. for methylphenidate, sleep problems rr 1.60 (95% ci 1.15-2.23). Fetched 2026-10-20 (HTTP 200). https://pmc.ncbi.nlm.nih.gov/articles/PMC9018091/
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