Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance dependence: a 24-week randomized placebo-controlled trial.

Abstract

AIM:

To test the efficacy and safety of osmotic release oral system (OROS) methylphenidate (MPH) in doses up to 180 mg/day to treat attention deficit hyperactivity disorder (ADHD) and prevent any drug relapse in individuals with a co-diagnosis of ADHD and amphetamine dependence.

DESIGN:

Randomized placebo-controlled 24-week double-blind trial with parallel groups design.

SETTING:

Participants were recruited from medium security prisons in Sweden. The medication started within 2 weeks before release from prison and continued in out-patient care with twice-weekly visits, including once-weekly cognitive behavioural therapy.

PARTICIPANTS:

Fifty-four men with a mean age of 42 years, currently incarcerated, meeting DSM-IV criteria for ADHD and amphetamine dependence.

MEASUREMENTS:

Change in self-reported ADHD symptoms, relapse to any drug use (amphetamine and other drugs) measured by urine toxicology, retention to treatment, craving and time to relapse.

FINDINGS:

The MPH-treated group reduced their ADHD symptoms during the trial (P = 0.011) and had a significantly higher proportion of drug-negative urines compared with the placebo group (P = 0.047), including more amphetamine-negative urines (P = 0.019) and better retention to treatment (P=0.032).

CONCLUSIONS:

Methylphenidate treatment reduces attention deficit hyperactivity disorder symptoms and the risk for relapse to substance use in criminal offenders with attention deficit hyperactivity disorder and substance dependence.

• Authors: Maija Konstenius, Nitya Jayaram-Lindström, Joar Guterstam, Olof Beck, Björn Philips, Johan Franck
• Journal: Addiction (Abingdon, England) (Addiction) Vol. 109 Issue 3 Pg. 440-9 (Mar 2014) ISSN: 1360-0443 [Electronic] England
• PMID: 24118269 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of The Society for the Study of Addiction.

Chemical References

• Central Nervous System Stimulants
• Delayed-Action Preparations
• Methylphenidate

Topics

• Adult
• Amphetamine-Related Disorders (psychology, therapy)
• Attention Deficit Disorder with Hyperactivity (psychology, therapy)
• Central Nervous System Stimulants (therapeutic use)
• Cognitive Behavioral Therapy (methods)
• Criminals
• Delayed-Action Preparations
• Double-Blind Method
• Humans
• Male
• Methylphenidate (therapeutic use)
• Middle Aged
• Secondary Prevention (methods)
• Sweden
• Treatment Outcome