Sustained release methylphenidate for the treatment of ADHD in amphetamine abusers: A pilot study

Konstenius, Maija; Jayaram‐Lindström, Nitya; Beck, Olof; Franck, Johan

doi:10.1016/j.drugalcdep.2009.11.006

Cited by 65 publications

(68 citation statements)

References 178 publications

(256 reference statements)

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“…Amphetamines are effective also in reducing cocaine use and improving ADHD symptoms for adults with comorbid ADHD and cocaine use disorder (Levin et al 2015). In contrast, methylphenidate is less effective in stimulant-dependent ADHD patients, possibly because of limited efficacy at DAT as a result of long-term stimulant abuse (Crunelle et al 2013; Konstenius et al 2010). …”

Section: Discussionmentioning

confidence: 99%

Adolescent d-amphetamine treatment in a rodent model of attention deficit/hyperactivity disorder: impact on cocaine abuse vulnerability in adulthood

et al. 2016

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Rationale Stimulant medications for Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescents remains controversial with respect to later development of cocaine abuse. Past research demonstrated that adolescent methylphenidate treatment increased several aspects of cocaine self-administration during adulthood using the Spontaneously Hypertensive Rat (SHR) model of ADHD. Presently, we determined effects of the alternate stimulant medication, d-amphetamine, on cocaine self-administration. Objectives We tested the hypothesis that adolescent d-amphetamine would not increase cocaine self-administration in adult SHR, given that d-amphetamine has a different mechanism of action than methylphenidate. Methods A pharmacologically relevant dose of d-amphetamine (0.5 mg/kg) or vehicle was administered throughout adolescence to SHR and two control strains, Wistar-Kyoto (WKY) and Wistar (WIS). Three aspects of cocaine abuse vulnerability were assessed in adulthood after discontinuing adolescent treatments: acquisition rate and dose-related responding under fixed (FR) and progressive (PR) ratio schedules. Results Adult SHR acquired cocaine self-administration faster and self-administered more cocaine across multiple doses compared to WKY and WIS under FR and PR schedules, indicating SHR is a reliable animal model of comorbid ADHD and cocaine abuse. Relative to vehicle, SHR and WIS with adolescent d-amphetamine treatment self-administered less cocaine upon reaching acquisition criteria, and WIS additionally acquired cocaine self-administration more slowly and had downward shifts in FR and PR cocaine dose-response curves. WKY with adolescent d-amphetamine treatment acquired cocaine self-administration more quickly relative to vehicle. Conclusions In contrast to methylphenidate, adolescent d-amphetamine did not augment cocaine self-administration in SHR. Adolescent d-amphetamine treatment actually protected against cocaine abuse vulnerability in adult SHR and WIS.

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Section: Discussionmentioning

confidence: 99%

Adolescent d-amphetamine treatment in a rodent model of attention deficit/hyperactivity disorder: impact on cocaine abuse vulnerability in adulthood

et al. 2016

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“…One study investigated ADHD prisoners with lifetime substance use; a marked improvement (effect size of d = 2.1) was found for ADHD symptoms, global severity of illness and global functioning, and no illicit drug use during the course of the trial when treated with methylphenidate (assessed by supervised urine drug screens) [59]. However, another trial examining amphetamine dependence comorbid to ADHD found no benefit for methylphenidate on substance outcomes, albeit finding a positive effect for ADHD symptoms [60]. Two trials examining stimulant medication (lis-dexamphetamine dimesylate and methylphenidate) on smoking outcomes in those with ADHD found improvements for ADHD symptoms, but no effect for smoking cessation over placebo [61,62].…”

Section: Treatment Considerationsmentioning

confidence: 99%

Attention deficit hyperactivity disorder and substance misuse: an evaluation of causal hypotheses and treatment considerations

Young

Sedgwick

2015

Expert Review of Neurotherapeutics

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Attention deficit hyperactivity disorder (ADHD) is known to co-occur with substance misuse at a high rate. This has important health and legal implications for those with ADHD. Mechanisms that may influence drug use among those with ADHD are discussed and evaluated in this review, including self-medication, behavioral disinhibition, comorbidity, and sensitization. While no one hypothesis is able to explain the complex phenomenon of drug taking behaviors, it is likely that self-medication, disinhibition and comorbidity play a part, with little evidence for sensitization. The development of efficacious treatment is necessary to help those with this debilitating comorbidity, as there are currently few evidence-based interventions.

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“…Although ADHD medications have been shown efficient for improving ADHD symptoms in adults [18], evidence is less promising regarding the efficacy in individuals with SUD [19, 20], including those in OMT [21-23]. National guidelines regulate treatment with central stimulants for patients in OMT in a number of countries due to concern of combining these medications with strong opioids, thus restricting access to this treatment [22-24].…”

Section: Introductionmentioning

confidence: 99%

Attention Deficit Hyperactivity Disorder Symptoms are Common in Patients in Opioid Maintenance Treatment

et al. 2017

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Introduction and Aims: Knowledge of attention deficit hyperactivity disorder (ADHD) symptoms among patients in opioid maintenance treatment (OMT) is important for treatment optimization and yet limited. We investigated the prevalence of ADHD symptoms, and factors associated with high ADHD symptom burden in a group of Norwegian OMT patients. Methods: We interviewed individuals entering OMT across Norway in 2 steps between 2012 and 2016. ADHD symptoms were measured by the Adult ADHD Self-Report Scale (ASRS; n = 175). We compared 2 groups of individuals who scored above or below the clinical cutoff score. Mental distress was measured with the General Symptom Index (GSI) of the Hopkin’s Symptom Check-List-25. Results: A total of 33% of the OMT patients screened positively for ADHD on the ASRS. Participants who scored above the clinical cutoff were younger, and reported more severe substance use and mental distress. When controlling for other significant variables in a logistic regression analysis, scoring above cutoff on the ASRS was associated with higher GSI (OR 1.61; 95% CI 1.03–2.50) and use of stimulants (OR 2.55; 1.13–5.76). Conclusions: ADHD symptoms were common in these OMT patients. High ADHD symptom burden was associated with higher mental distress and use of stimulants. This underlines a need of more systematic focus on ADHD in OMT to plan treatment accordingly.

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Sustained release methylphenidate for the treatment of ADHD in amphetamine abusers: A pilot study

Cited by 65 publications

References 178 publications

Adolescent d-amphetamine treatment in a rodent model of attention deficit/hyperactivity disorder: impact on cocaine abuse vulnerability in adulthood

Adolescent d-amphetamine treatment in a rodent model of attention deficit/hyperactivity disorder: impact on cocaine abuse vulnerability in adulthood

Attention deficit hyperactivity disorder and substance misuse: an evaluation of causal hypotheses and treatment considerations

Attention Deficit Hyperactivity Disorder Symptoms are Common in Patients in Opioid Maintenance Treatment

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