Methylphenidate treatment for cocaine abusers with adult attention-deficit/hyperactivity disorder: a pilot study.

• Abstract: BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is common among cocaine abusers seeking treatment. This open trial was carried out to assess the efficacy of sustained-release methylphenidate for the treatment of cocaine abuse among individuals with ADHD. METHOD: Twelve patients who met DSM-IV diagnostic criteria for adult ADHD and cocaine dependence were entered into a 12-week trial of divided daily doses of sustained-release methylphenidate ranging from 40 to 80 mg. In addition to the pharmacotherapy, patients also received individual weekly relapse prevention therapy. Individuals were assessed weekly for ADHD symptoms; vital signs and urine toxicologies were obtained 3 times a week. RESULTS: Of the 12 patients entered, 10 completed at least 8 weeks of the study and 8 completed the entire study. Using both a semistructured clinical interview and a self-report assessment, patients reported reductions in attention difficulties, hyperactivity, and impulsivity. Self-reported cocaine use and craving decreased significantly. More importantly, cocaine use, confirmed by urine toxicologies, also decreased significantly. CONCLUSION: These preliminary data suggest that under close supervision, the combined intervention of sustained-release methylphenidate and relapse prevention therapy may be effective in treating individuals with both adult ADHD and cocaine dependence.
• Authors: F R Levin, S M Evans, D M McDowell, H D Kleber (Affiliation: Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York 10032, USA.)
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 59 Issue 6 Pg. 300-5 (Jun 1998) ISSN: 0160-6689 [Print] UNITED STATES
• PMID: 9671342 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Delayed-Action Preparations
• Methylphenidate
• Cocaine

Topics

• Adult
• Ambulatory Care
• Attention Deficit Disorder with Hyperactivity (drug therapy, epidemiology)
• Behavior Therapy
• Cocaine (urine)
• Cocaine-Related Disorders (drug therapy, epidemiology, prevention & control)
• Combined Modality Therapy
• Comorbidity
• Delayed-Action Preparations
• Drug Administration Schedule
• Female
• Humans
• Male
• Methylphenidate (administration & dosage, therapeutic use)
• Personality Inventory
• Pilot Projects
• Psychiatric Status Rating Scales
• Recurrence (prevention & control)
• Substance Abuse Detection