Central Nervous System Stimulants, but Not Antidepressants, Are Associated with Lower Physical Activity in U.S. Youth: NHANES 2017-March 2020.

Background/Objectives: Although psychopharmacotherapy and physical activity may benefit children with mental disorders, the association of psychotropic medications with physical activity remains unclear. The study evaluated the association between exposure to antidepressants or central nervous system (CNS) stimulants and the likelihood of meeting the Centers for Disease Control and Prevention (CDC) physical activity guidelines (≥60 min of moderate-to-vigorous physical activity daily) among U.S. children. Methods: We used data from the 2017-March 2020 National Health and Nutrition Examination Survey (NHANES) to quantify medication use and physical activity duration. The exposure to antidepressants and CNS stimulants in children and their level of physical activity were captured via interviews with pediatric participants and their adult proxies. The proportion of children meeting the CDC-recommended physical activity level was compared between propensity-score-matched antidepressant users vs. non-users, as well as matched CNS-stimulant users and non-users, using Rao-Scott chi-square tests. Results: Among 3835 NHANES participants aged 2-17 years, representing approximately 59.4 million U.S. children, 0.89% used antidepressants, and 2.40% used CNS stimulants. After accounting for age, sex, race/ethnicity, body mass index (BMI), and family income, a smaller proportion of CNS stimulant users met physical activity guidelines compared with non-users (22.06% vs. 37.02%; p = 0.0075). Antidepressant use was not significantly associated with physical activity level (12.06% vs. 15.52%; p = 0.6342). Conclusions: These findings highlight the importance of monitoring activity patterns among youth prescribed CNS stimulants and antidepressants, particularly integrating physical activity promotion into public health strategies.