To the Editor.
—The article by Dr Cuttler and colleagues1 and the accompanying Editorial2 highlight the complex interactions between biological and social forces leading to the recommendation to treat or not treat short stature not caused by growth hormone deficiency (non-GHD). While the authors raise ethical concerns about issues of enhancement with new biopharmaceuticals, the articles bring to mind another condition, also primarily of children, in which similar dilemmas already exist: attention-deficit hyperactivity disorder (ADHD) and its main medical treatment, the use of stimulant medication (methylphenidate hydrochloride or amphetamine sulfate).There are many similarities and a few critical differences in deciding on treatment for a child with ADHD vs treatment for one with non-GHD. Medication as a sole treatment for ADHD also has not been proven to alter long-term outcomes.3 Nevertheless, compared with recombinant growth hormone, the stimulants are fairly inexpensive, have a rather impressive safety record
Diller L. Use of Growth Hormone for Non—Growth Hormone Deficient Children. JAMA. 1996;276(23):1877–1878. doi:10.1001/jama.1996.03540230027026
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