Does Sertraline stunt growth? (3+ factors)

In this article, we will discuss the potential impact of Sertraline on growth during childhood and adolescence. We will also list different research findings on the correlation between Sertraline use and growth and the risks and benefits associated.

Does Sertraline stunt growth?

Yes, Sertraline does stunt growth. Sertraline has been associated with reduced growth in height when used in early childhood and adolescence. Not many studies have been conducted on the cause of stunted growth, but the very few that have examined the effect of SSRIs on height report the same (1,2).

Sertraline belongs to a class called selective serotonin reuptake inhibitors (SSRIs) and is a commonly prescribed anti-depressant medication used to manage and treat major depressive disorder, obsessive-compulsive disorder, panic disorder, and many other depressive illnesses (3).

It can be a cause of concern among parents of children receiving Sertraline, and healthcare professionals due to this effect.

How does Sertraline impact growth?

SSRIs, including Sertraline, are thought to reduce growth hormone (GH) secretion. GH is a hormone responsible for the majority of the growth processes within the human body. SSRIs impair the secretion of GH via selective impairment of the somatotropic axis in the brain (4).

As children need more GH to support the growth spurts, a decreased secretion of GH can be the cause of stunted growth in children.

If GH deficiency remains unaddressed in children it can cause long-term growth problems like short stature, cardiovascular risks, decreased bone mineral density, and delayed puberty, which may not be reversible on cessation of Sertraline therapy.

If your child is on Sertraline or any other SSRI and you are concerned about the growth of your child it is advised to contact your healthcare provider for a thorough assessment of the risks and benefits related to Sertraline use.

What does research suggest?

Only a limited amount of studies have been conducted on the relationship between SSRI usage and GH reduction. SSRIs, including Sertraline, have been shown to cause a decrease in GH and as a result, a decrease in growth in almost all studies conducted (1,4,5,6).

This decreased GH has not only been seen in children but also in adults. Adults do not see the major effect of growth stunting but do see adverse changes in cardiovascular function and carbohydrate and lipid metabolism (5,6).

In addition, when assessed in children and adolescents, this relation becomes more prominent due to the reason that children need more growth hormone during the growing years (4). SSRI-related longitudinal growth reduction has also been reported in boys going through puberty (2).

Children also have different metabolic rates, hormone levels and neurotransmitter systems, which makes it likely for some side effects to be more common among younger children and adolescents rather than adults.

Stunted growth may be of concern in younger children, due to prolonged antidepressant use, which causes a suppression effect from serotonin on growth hormone secretion (7,8).

The long-term effects of Sertraline on growth reduction have not yet been thoroughly assessed, but one recent study shows that in moderate doses, no such effect is seen and growth results are consistent with normal development.

The only consistent change noted was in the side effect of weight loss because there was a positive difference in weight after ceasing Sertraline intake (9).

What other factors influence growth while on Sertraline?

There are various factors which can influence the growth of children and adolescents using Sertraline including (4,8):

• Dosage of Sertraline – high doses of the medication result in increased inhibition of GH secretion influencing growth, especially in children
• Duration of treatment with Sertraline – prolonged antidepressant use in children can cause increased suppression of GH which can cause stunted growth
• Age of patient – the age of the patient receiving Sertraline matters as children and adolescents, are more prone to the effects of GH deficiency
• Gastrointestinal distress – Sertraline is known to cause gastrointestinal problems like nausea, vomiting and diarrhoea which can hinder the absorption of food depriving the body of nutrients needed for growth
• Decreased appetite – Sertraline can cause a decrease in appetite in patients receiving the medication which can lead to decreased intake of nutritious food needed for ample growth in children

While this may not be the case with all patients receiving Sertraline, these factors are to be considered when addressing stunted growth while taking Sertraline.

How to monitor growth while taking Sertraline?

Monitoring your child’s growth while on Sertraline is very important. Continuous monitoring while taking Sertraline is crucial to assess growth reduction.

Especially, recording younger children’s responsiveness to Sertraline, along with various height and weight monitoring tools and measurement charts can help you monitor growth in your child (8).

It is recommended to keep a weighing scale at home to keep track of your child’s weight. You can also make a chart recording the height, weight and BMI of your child so you can monitor growth.

Your healthcare provider may also schedule appointments just to check the weight and height of your child to make sure everything is okay.

What to do if Sertraline is causing stunted growth?

If you suspect that growth reduction in your child is due to Sertraline, talk to your healthcare provider, about the underlying issue.

Your healthcare provider will assess both short and long-term risks and benefits associated and may adjust the dosage to reduce Sertraline-related growth reduction. Your healthcare provider may also prescribe another medication with fewer side effects.

Options to counteract growth inhibition by Sertraline:

Growth hormone (GH) therapy:

If switching medication is not an option then your doctor may prescribe synthetic GH to make up for the deficiency caused by Sertraline. This therapy is given as a daily injection and it helps with the GH deficiency caused by Sertraline.

Growth hormone injection therapy is fairly safe for most children and side effects are very rare. But if your child is prescribed this therapy you should watch out for side effects like knee or hip pain, allergic reactions, headaches or an increase in blood sugar levels.

If your child experiences any of these side effects you should immediately contact your healthcare provider.

Healthy lifestyle:

Healthy eating is another option available which can help increase GH production naturally. You should focus on maintaining a balanced diet and good sleep habits. Be sure to include foods rich in melatonin and tryptophan because they are found to increase GH in the body.

Foods like meat, spinach, eggs, milk, fish and beans can boost GH production. Reduction of refined carbohydrates in diet, and an ample amount of sunlight can also help increase GH levels. Intermittent fasting and melatonin or arginine supplementation are also beneficial for GH levels.

Proper nutrition for you or your child, whoever is taking the medication is essential in keeping your GH levels normal.

Conclusion

In this article, we have discussed stunted growth related to Sertraline use, especially in younger children. We have examined various research studies and how to manage if growth reduction occurs.

References