Methylphenidate for Attention Deficit Hyperactivity Disorder and Drug Relapse in Criminal Offenders with Substance Dependence: a 24-week Randomized Placebo-controlled Trial

Overview

Journal Addiction

Specialty Psychiatry

Date 2013 Oct 15

PMID 24118269

Citations 60

Authors

Maija Konstenius

Nitya Jayaram-Lindstrom

Joar Guterstam

Olof Beck

Bjorn Philips

Johan Franck

Affiliations

Soon will be listed here.

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.

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References

Biederman J, Mick E, Surman C, Doyle R, Hammerness P, Harpold T . A randomized, placebo-controlled trial of OROS methylphenidate in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005; 59(9):829-35. DOI: 10.1016/j.biopsych.2005.09.011. View

Levin F, Evans S, Brooks D, Kalbag A, Garawi F, Nunes E . Treatment of methadone-maintained patients with adult ADHD: double-blind comparison of methylphenidate, bupropion and placebo. Drug Alcohol Depend. 2005; 81(2):137-48. DOI: 10.1016/j.drugalcdep.2005.06.012. View

Rosler M, Retz W, Retz-Junginger P, Hengesch G, Schneider M, Supprian T . Prevalence of attention deficit-/hyperactivity disorder (ADHD) and comorbid disorders in young male prison inmates. Eur Arch Psychiatry Clin Neurosci. 2004; 254(6):365-71. DOI: 10.1007/s00406-004-0516-z. View

Roache J, Grabowski J, Schmitz J, CRESON D, Rhoades H . Laboratory measures of methylphenidate effects in cocaine-dependent patients receiving treatment. J Clin Psychopharmacol. 2000; 20(1):61-8. DOI: 10.1097/00004714-200002000-00011. View

Karlsson A, Gustavsson H, Mansson S, McAuley K, Back S . Dose integration characteristics in normoxic polymer gel dosimetry investigated using sequential beam irradiation. Phys Med Biol. 2007; 52(15):4697-706. DOI: 10.1088/0031-9155/52/15/021. View

van Emmerik-van Oortmerssen K, Van de Glind G, van den Brink W, Smit F, Crunelle C, Swets M . Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis. Drug Alcohol Depend. 2012; 122(1-2):11-9. DOI: 10.1016/j.drugalcdep.2011.12.007. View

Ginsberg Y, Hirvikoski T, Lindefors N . Attention Deficit Hyperactivity Disorder (ADHD) among longer-term prison inmates is a prevalent, persistent and disabling disorder. BMC Psychiatry. 2010; 10:112. PMC: 3016316. DOI: 10.1186/1471-244X-10-112. View

Ward M, Wender P, Reimherr F . The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry. 1993; 150(6):885-90. DOI: 10.1176/ajp.150.6.885. View

Love A, James D, Willner P . A comparison of two alcohol craving questionnaires. Addiction. 1998; 93(7):1091-102. DOI: 10.1046/j.1360-0443.1998.937109113.x. View

10.

GUSTAVSSON E, Andersson M, Stephanson N, Beck O . Validation of direct injection electrospray LC-MS/MS for confirmation of opiates in urine drug testing. J Mass Spectrom. 2007; 42(7):881-9. DOI: 10.1002/jms.1219. View

11.

Hakansson A, Schlyter F, Berglund M . Characteristics of primary amphetamine users in Sweden: a criminal justice population examined with the Addiction Severity Index. Eur Addict Res. 2008; 15(1):10-8. DOI: 10.1159/000173004. View

12.

Spencer T, Biederman J, Wilens T, Doyle R, Surman C, Prince J . A large, double-blind, randomized clinical trial of methylphenidate in the treatment of adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005; 57(5):456-63. DOI: 10.1016/j.biopsych.2004.11.043. View

13.

Levin F, Evans S, Brooks D, Garawi F . Treatment of cocaine dependent treatment seekers with adult ADHD: double-blind comparison of methylphenidate and placebo. Drug Alcohol Depend. 2006; 87(1):20-9. DOI: 10.1016/j.drugalcdep.2006.07.004. View

14.

Volkow N, Fowler J, Wang G, Swanson J . Dopamine in drug abuse and addiction: results from imaging studies and treatment implications. Mol Psychiatry. 2004; 9(6):557-69. DOI: 10.1038/sj.mp.4001507. View

15.

Hammerness P, Wilens T, Berul C, Elkort M . Supraventricular tachycardia in an adolescent with attention-deficit/hyperactivity disorder (ADHD). J Am Acad Child Adolesc Psychiatry. 2008; 47(2):219-220. DOI: 10.1097/chi.0b013e31815d7485. View

16.

Adler L, Zimmerman B, Starr H, Silber S, Palumbo J, Orman C . Efficacy and safety of OROS methylphenidate in adults with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, double-blind, parallel group, dose-escalation study. J Clin Psychopharmacol. 2009; 29(3):239-47. DOI: 10.1097/JCP.0b013e3181a390ce. View

17.

Gordon M, Kinlock T, Schwartz R, OGrady K . A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release. Addiction. 2008; 103(8):1333-42. PMC: 2582162. DOI: 10.1111/j.1360-0443.2008.002238.x. View

18.

Lichtenstein P, Halldner L, Zetterqvist J, Sjolander A, Serlachius E, Fazel S . Medication for attention deficit-hyperactivity disorder and criminality. N Engl J Med. 2012; 367(21):2006-14. PMC: 3664186. DOI: 10.1056/NEJMoa1203241. View

19.

Kinlock T, Battjes R, Schwartz R . A novel opioid maintenance program for prisoners: report of post-release outcomes. Am J Drug Alcohol Abuse. 2005; 31(3):433-54. DOI: 10.1081/ada-200056804. View

20.

Wilens T, Morrison N, Prince J . An update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adults. Expert Rev Neurother. 2011; 11(10):1443-65. PMC: 3229037. DOI: 10.1586/ern.11.137. View