The efficacy of stimulant treatment in patients with
substance use disorders and comorbid
attention deficit hyperactivity disorder (
ADHD) has been tested for
cocaine and
alcohol dependence but so far no studies have been conducted in
amphetamine dependent individuals. The present trial was a pilot study aiming to test the feasibility of treating
amphetamine dependent patients with comorbid
ADHD with
central stimulant medication. The study was a double-blind, placebo controlled trial with parallel groups design comparing the efficacy of a fixed dose (72mg) of OROS
methylphenidate (MPH) with placebo (PL) in reducing
ADHD symptoms in currently abstinent adults with
amphetamine dependence and
ADHD. Twenty-four treatment seeking patients who met the DSM IV criteria for
amphetamine dependence and
ADHD were randomized to MPH/PL. The trial was conducted at an outpatient facility with twice weekly visits, measuring
ADHD symptoms and
drug use. Patients rated their
ADHD symptoms on a weekly basis and provided supervised urine specimens for
drug toxicology twice weekly. All patients participated in weekly sessions of a skills training programme. Both the groups significantly reduced their self-rated
ADHD symptoms during the 12-week treatment but there was no difference between the two treatment arms.
Drug use, both measured by urine toxicology and self-report did not differ between the groups. No difference was found between the two groups with regards to craving for
amphetamine or in retention in treatment. Larger studies with higher doses combined with individual dosage and longer follow-up periods are warranted.