Stimulant-induced changes in smoking and caloric intake: Influence of rate of onset

Vansickel, Andrea R.; Poole, Megan; Stoops, William W.; Hays, Karolyn E.; Upchurch, Margaret; Glaser, Paul E.A.; Rush, Craig R.

doi:10.1016/j.pbb.2009.02.012

Cited by 10 publications

(19 citation statements)

References 25 publications

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“…Results of previous studies from our laboratory demonstrate that methylphenidate, regardless of formulation type (i.e., sustained or immediate-release), increases ad libitum cigarette smoking in non-ADHD adults (Rush et al 2005; Vansickel et al 2007, 2009). In those studies, participants were administered sustained or immediate-release methylphenidate and were allowed to smoke ad libitum for 4 h during the peak effects of the medication.…”

Section: Introductionmentioning

confidence: 73%

“…Sessions were videotaped and scored for various smoking behaviors. In all studies, at least one dose of methylphenidate increased the total number of puffs significantly compared to placebo (Rush et al 2005; Vansickel et al 2007, 2009). In another study from our laboratory, methylphenidate was shown to increase the choice of cigarettes over money (Stoops et al 2011).…”

Section: Introductionmentioning

confidence: 90%

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Methylphenidate increases cigarette smoking in participants with ADHD

et al. 2011

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Rationale Methylphenidate (Ritalin®) is commonly prescribed for behavioral problems associated with attention deficit/hyperactivity disorder (ADHD). The results of previous studies suggest that methylphenidate increases cigarette smoking in participants without psychiatric diagnoses. Whether methylphenidate increases cigarette smoking in participants diagnosed with ADHD is unknown. Objective In this within-subjects, repeated measures experiment, the acute effects of a range of doses of methylphenidate (10, 20, and 40 mg) and placebo were assessed in nine cigarette smokers who were not attempting to quit and met diagnostic criteria for ADHD but no other Axis I psychiatric disorders other than nicotine dependence. Methods Each dose of methylphenidate was tested once while placebo was tested twice. One hour after ingesting drug, participants were allowed to smoke ad libitum for 4 h. Measures of smoking included total cigarettes smoked, total puffs, and carbon monoxide levels. Snacks and decaffeinated drinks were available ad libitum; caloric intake during the 4-h smoking session was calculated. Results Methylphenidate increased the total number of cigarettes smoked, total number of puffs, and carbon monoxide levels. Methylphenidate decreased the number of food items consumed and caloric intake. Conclusions The results of this experiment suggest that acutely administered methylphenidate increases cigarette smoking in participants with ADHD, which is concordant with findings from previous studies that tested healthy young adults. These data indicate that clinicians may need to consider non-stimulant options or counsel their patients before starting methylphenidate when managing ADHD-diagnosed individuals who smoke.

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Section: Introductionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 90%

Methylphenidate increases cigarette smoking in participants with ADHD

et al. 2011

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“…One class of medications that can be used for both weight management and sedation is stimulants. Unfortunately, it has been shown that both methylphenidate [44] and modafinil [45] increase tobacco smoking. However, atomoxetine (a nonstimulant that is used to treat attention-deficit hyperactivity disorder) does not appear to increase smoking [46] and there is one study with a small sample size (n = 12) that shows an insignificant but overall decrease in smoking in persons with schizophrenia on atomoxetine.…”

Section: Smoking To 'Self-medicate' Antipsychotic Side Effectsmentioning

confidence: 99%

The Role of Antipsychotics in Smoking and Smoking Cessation

2011

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Persons with severe and persistent mental illnesses, e.g. schizophrenia spectrum disorders and bipolar disorder, smoke at a much higher rate than the general population. Treatment options for schizophrenia spectrum disorders and bipolar disorder often include the first-generation (typical) and second-generation (atypical) antipsychotics, which have been shown to be effective in treating both psychotic and mood symptoms. This article reviews studies examining the relationship between antipsychotic medication and cigarette smoking. These studies suggest that in persons with schizophrenia and schizoaffective disorder, typical antipsychotics may increase basal smoking and decrease people's ability to stop smoking, whereas atypical antipsychotics decrease basal smoking and promote smoking cessation. However, we found that the data available were generally of moderate quality and from small studies, and that there were conflicting findings. The review also critically assesses a number of potential mechanisms for this effect: the use of smoking as a form of self-medication for the side effects of antipsychotics, the effect of antipsychotics on smoking-related cues and the effect of antipsychotics on the appreciation of the economic cost of smoking behaviour. Gaps in the research are noted and recommendations for further study are included. More study of this important issue is needed to clarify the effect of antipsychotics on smoking behaviours.

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“…[34][35][36][37][38][39][40] Although clinical trials of treatmentseeking smokers with ADHD have shown that neither methylphenidate nor amphetamine increase smoking, 41,42 studies have not examined how stimulant treatment might influence naturalistic smoking among individuals with ADHD who are not trying to quit. Such studies are necessary to resolve this discrepancy between laboratory studies and clinical trials of smoking cessation.…”

Section: Limitationsmentioning

confidence: 99%

“…Several laboratory studies, including 1 with ADHD smokers, have revealed that methylphenidate or amphetamine increase cigarette smoking. [34][35][36][37][38][39] In contrast, however, a recent study revealed no effect of methylphenidate on choices of cigarette puffs versus money for ADHD and non-ADHD adults. 40 Randomized clinical trials of stimulants to aid cessation among ADHD smokers have revealed no evidence that either methylphenidate or amphetamine products are more effective than placebo for facilitating smoking abstinence.…”

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confidence: 90%

Stimulant Treatment of ADHD and Cigarette Smoking: A Meta-Analysis

2014

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BACKGROUND AND OBJECTIVE: Individuals with attention-deficit/ hyperactivity disorder (ADHD) have a significantly higher risk of cigarette smoking. The nature of the relationship between smoking and psychostimulant medications commonly used to treat ADHD is controversial. Our objective was to examine the relationship between stimulant treatment of ADHD and cigarette smoking by using meta-analysis, and to identify study and sample characteristics that moderate this relationship. METHODS:Literature searches on PubMed and PsycInfo databases identified published studies for inclusion. Included studies compared cigarette smoking outcomes for stimulant-treated and untreated ADHD individuals. Seventeen studies met inclusion criteria, and 14 (total n = 2360) contained sufficient statistical information for inclusion in the meta-analysis. Two authors extracted odds ratios or frequencies of smokers in the treatment or nontreatment groups, and coded study characteristics including sample source, percentage of male participants, follow-up length, treatment consistency, type of smoking measure, prospective study, and controlling for comorbidities. RESULTS:Meta-analysis revealed a significant association between stimulant treatment and lower smoking rates. Meta-regression indicated that effect sizes were larger for studies that used clinical samples, included more women, measured smoking in adolescence rather than adulthood, conceptualized stimulant treatment as consistent over time, and accounted for comorbid conduct disorder. CONCLUSIONS:Nearly all studies were naturalistic, precluding causal inferences. Available data were insufficient to examine additional influences of patient demographics, treatment effectiveness, or other comorbidities. Consistent stimulant treatment of ADHD may reduce smoking risk; the effect was larger in samples with more severe psychopathology. Implications for further research, treatment of ADHD, and smoking prevention are discussed.

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Stimulant-induced changes in smoking and caloric intake: Influence of rate of onset

Cited by 10 publications

References 25 publications

Methylphenidate increases cigarette smoking in participants with ADHD

Methylphenidate increases cigarette smoking in participants with ADHD

The Role of Antipsychotics in Smoking and Smoking Cessation

Stimulant Treatment of ADHD and Cigarette Smoking: A Meta-Analysis

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