Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance dependence: a 24‐week randomized placebo‐controlled trial2. (1st December 2013)

• Record Type: Journal Article
• Authors: Konstenius, Maija; Jayaram‐Lindström, Nitya; Guterstam, Joar; Beck, Olof; Philips, Björn; Franck, Johan
• Is Part Of: Addiction. Volume 109:Number 3(2014:Mar.)
• Page Start: 440
• Page End: 449
• Publication Date: 2013-12-01
• Subjects: Alcoholism -- Periodicals; Drug addiction -- Periodicals; 616.86
• DOI: 10.1111/add.12369
• Languages: English
• ISSNs: 0965-2140

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="add12369-sec-0001" sec-type="section"> <title>Aim</title> <p>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.</p> </sec> <sec id="add12369-sec-0002" sec-type="section"> <title>Design</title> <p>Randomized placebo‐controlled 24‐week double‐blind trial with parallel groups design.</p> </sec> <sec id="add12369-sec-0003" sec-type="section"> <title>Setting</title> <p>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.</p> </sec> <sec id="add12369-sec-0004" sec-type="section"> <title>Participants</title> <p>Fifty‐four men with a mean age of 42 years, currently incarcerated, meeting DSM‐IV criteria for ADHD and amphetamine dependence.</p> </sec> <sec id="add12369-sec-0005" sec-type="section"> <title>Measurements</title> <p>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.</p> </sec> <sec id="add12369-sec-0006" sec-type="section"> <title>Findings</title> <p>The MPH‐treated group reduced their ADHD symptoms during the trial (<italic>P</italic> = 0.011) and had a significantly higher proportion of drug‐negative urines compared with the placebo group (<italic>P</italic> = 0.047), including more amphetamine‐negative urines (<italic>P</italic> = 0.019) and better retention to treatment (<italic>P</italic> = 0.032).</p> </sec> <sec id="add12369-sec-0007" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>