Endocrine Abstracts

Aims: Attention Deficit Disorder & Hyperactivity Syndrome (ADHD) is identify attention deficit,impulsivity hyperactivity before the age of seven years old. ADHD is a serious disease which could cause corruption of daily lifetime and needed to be taken psychostimulant drugs. This case brings on that these kind of drugs can have unexplored side effects. In this study; it was reported 7 precocious puberty (PP) cases which used methylphenidate due to ADHD and investigated interrelation between methylphenidate and precocious puberty.

Methods: This study consisted 7 cases which used methylphenidate due to ADHD. All the cases with various pubertal complaints were admitted for family history, a detail physical examination, pubertal staging and anthropometric evaluations. Puberty precocious (PP) was diagnosed on the appearance of breast development before the age of 8 years in girls and testes enlargement before 9 years in boys. The initial evaluation of cases with PP included determinations of height, weight, pubertal stage, bone age, pelvic ultrasound, neuroradiological imaging and evaluation of the hypothalamic-pituitary-ovarian axis by measuring basal and GnRH stimulated LH and FSH peaks, and the plasma concentration of estradiol. Patients were followed for at least 6 months after diagnosis was made.

Results: The study group consisted 7 precocious puberty (PP) cases (4 girls, 3 boys; the mean age 10.7±2.9 years old) with ADHD. Breast development in 4 girls and testis enlargement in 3 boy cases were determined\. Basal hormonal levels (thyroid-surrenal-prolactin) were normal range. Results of LHRH stimulation tests in all the cases were demonstrated central pubertal responses. Radiologic evaluations of hypotalomohypophisial region were normal in all the cases. One of the cases which developed pubertal progression in follow-up was started on GnRH analoque theraphy.

Conclusion: Glutamine, dopamine and noradrenaline are most important excitatory neurotransmitters that have a role in the starting of puberty. Depending on the effect of methylphenidate cumulating of dopamine and noradrenaline in the synaps gap could cause inducing puberty by effecting its own receptor. As a result; using psychostimulant drugs at childhood may accelerate puberty.

Keywords Attention Deficit Disorder and Hyperactivity Syndrome Methylphenidate Central