Treatment of cocaine dependent treatment seekers with adult ADHD: Double-blind comparison of methylphenidate and placebo

Levin, Frances R.; Evans, Suzette M.; Brooks, Daniel J.; Garawi, Fatima

doi:10.1016/j.drugalcdep.2006.07.004

Cited by 189 publications

(188 citation statements)

References 47 publications

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“…Our results showing a treatment effect for MPH on ADHD symptoms in adolescents with illicit SUD are in contrast with some randomized clinical trials with stimulants in adults (19)(20)(21). A combination of factors, such as MPH dosage, type of MPH delivery system, type of abused drug, and brain development stage might explain these contradictory findings.…”

Section: Discussioncontrasting

confidence: 55%

“…All of them reported significant treatment effects in reducing ADHD symptoms. Interestingly, first line medications for ADHD were recently evaluated in adults with the comorbidity, with a positive result regarding ADHD symptoms (18), and most of the few available randomized clinical trials did not find a superior effect of MPH over placebo (19,20), or over placebo and bupropion (21) on ADHD symptoms. These findings may not necessarily be translated to adolescents, since there are reports of different MPH (22) and drug responses (23,24) between adults and adolescents.…”

Section: Introductionmentioning

confidence: 99%

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A randomized crossover clinical study showing that methylphenidate-SODAS improves attention-deficit/hyperactivity disorder symptoms in adolescents with substance use disorder

Szobot

Rohde

Katz

et al. 2008

Braz J Med Biol Res

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Our objective was to evaluate the effectiveness of a long-acting formulation of methylphenidate (MPH-SODAS) on attentiondeficit/hyperactivity disorder (ADHD) symptoms in an outpatient sample of adolescents with ADHD and substance use disorders (SUD). Secondary goals were to evaluate the tolerability and impact on drug use of MPH-SODAS. This was a 6-week, singleblind, placebo-controlled crossover study assessing efficacy of escalated doses of MPH-SODAS on ADHD symptoms in 16 adolescents with ADHD/SUD. Participants were randomly allocated to either group A (weeks 1-3 on MPH-SODAS, weeks 4-6 on placebo) or group B (reverse order). The primary outcome measures were the Swanson, Nolan and Pelham Scale, version IV (SNAP-IV) and the Clinical Global Impression Scale (CGI). We also evaluated the adverse effects of MPH-SODAS using the Barkley Side Effect Rating Scale and subject reports of drug use during the study. The sample consisted of marijuana (N = 16; 100%) and cocaine users (N = 7; 43.8%). Subjects had a significantly greater reduction in SNAP-IV and CGI scores (P < 0.001 for all analyses) during MPH-SODAS treatment compared to placebo. No significant effects for period or sequence were found in analyses with the SNAP-IV and CGI scales. There was no significant effect on drug use. MPH-SODAS was well tolerated but was associated with more severe appetite reduction than placebo (P < 0.001). MPH-SODAS was more effective than placebo in reducing ADHD symptoms in a non-abstinent outpatient sample of adolescents with comorbid SUD. Randomized clinical trials, with larger samples and SUD intervention, are recommended.

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Section: Discussioncontrasting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

A randomized crossover clinical study showing that methylphenidate-SODAS improves attention-deficit/hyperactivity disorder symptoms in adolescents with substance use disorder

Szobot

Rohde

Katz

et al. 2008

Braz J Med Biol Res

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“…Other medication trials for ADHD in adults undergoing SUD treatment also found large ADHD responses in their placebo + CBT groups. [7][8][9] Interestingly, a recent study supporting the efficacy of CBT for ADHD in adults used a treatment that is remarkably similar to our CBT for SUD. 29 Both manual-standardized treatments are individual, use motivational interviewing and psychoeducation, and include modules on communication skills, problem solving, and anger management.…”

Section: Discussionmentioning

confidence: 70%

“…Therefore, there may be significant overlap between the CBT treatment for SUD and a proven CBT treatment for ADHD. Furthermore, the fact that the three positive ADHD medication trials in subjects with SUD did not include a psychosocial treatment 5,6,10 and that all the studies that did include a psychosocial treatment have been negative [7][8][9] supports the possibility that the CBT may have had an impact on ADHD.…”

Section: Discussionmentioning

confidence: 99%

“…Second, no study has shown a clear difference between active medication and placebo in patients with ADHD who are in SUD treatment. Interestingly, all three studies that included patients in outpatient SUD treatment attributed the reduction in ADHD symptoms in the placebo group to the CBT psychosocial intervention, [7][8][9] and the only studies to find a difference between medication and placebo did not allow concurrent SUD treatment. 5,6,10 However, it is not known if these findings apply to adolescents enrolled in substance treatment, and the impact of ADHD treatment on both ADHD and SUD in this population is not known.…”

Section: Introductionmentioning

confidence: 99%

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Randomized, Controlled Trial of Atomoxetine for Attention-Deficit/Hyperactivity Disorder in Adolescents With Substance Use Disorder

Thurstone

Riggs

Salomonsen‐Sautel

et al. 2010

Journal of the American Academy of Child & Adolescent Psych

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Objective-To evaluate the effect of atomoxetine hydrochloride versus placebo on attentiondeficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) in adolescents receiving motivational interviewing / cognitive behavioral therapy (MI/CBT) for SUD.Method-This single-site, randomized, controlled trial was conducted between December 2005 and February 2008. Seventy adolescents (13-19 years) with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) ADHD, a DSM-IV ADHD checklist score greater than or equal to 22, and at least one non-tobacco SUD were recruited from the community. All subjects received 12 weeks of atomoxetine hydrochloride + MI/CBT versus placebo + MI/CBT. The main outcome measure for ADHD was self-report DSM-IV ADHD checklist score. For SUD, the main outcome was self-report number of days used non-tobacco substances in the past 28 days using the Timeline Followback interview.Results-Change in ADHD scores did not differ between atomoxetine + MI/CBT and placebo + MI/CBT (F4,191 = 1.23, p = 0.2975). Change in days used non-nicotine substances in the last 28 days did not differ between groups (F3,100 = 2.06, p = 0.1103).Conclusions-There was no significant difference between the atomoxetine + MI/CBT and placebo + MI/CBT groups in ADHD or substance use change. The MI/CBT and/or a placebo effect may have contributed to a large treatment response in the placebo group.

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Comparison of Treatments for Cocaine Use Disorder Among Adults

et al. 2021

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Treatment of cocaine dependent treatment seekers with adult ADHD: Double-blind comparison of methylphenidate and placebo

Cited by 189 publications

References 47 publications

A randomized crossover clinical study showing that methylphenidate-SODAS improves attention-deficit/hyperactivity disorder symptoms in adolescents with substance use disorder

A randomized crossover clinical study showing that methylphenidate-SODAS improves attention-deficit/hyperactivity disorder symptoms in adolescents with substance use disorder

Randomized, Controlled Trial of Atomoxetine for Attention-Deficit/Hyperactivity Disorder in Adolescents With Substance Use Disorder

Comparison of Treatments for Cocaine Use Disorder Among Adults

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