Double-blind placebo-controlled trial of methylphenidate in the treatment of adult ADHD patients with comorbid cocaine dependence.
Abstract
In this 12-week double-blind placebo-controlled trial of methylphenidate (MTP) versus placebo in 48 cocaine-dependent attention-deficit/hyperactivity disorder (ADHD) adults, the authors sought to determine whether MTP would be safe, control ADHD symptoms, and affect cocaine use. Efficacy indexes revealed significantly greater ADHD symptom relief in the MTP group. There were no group differences in self-reported cocaine use, urinalysis results, or cocaine craving. Because of the relatively small sample size, the results are preliminary. However, we found that MTP improved subjective reports of ADHD symptoms and did not worsen cocaine use while participants were in treatment.
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For patients with cocaine intoxication and cardiovascular disease, beta blockers are generally considered contraindicated.
“Beta blockers are generally contraindicated in patients with cocaine intoxication and cardiovascular disease 246 ; this is an area of ongoing controversy in the field.”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [246]
Concerns that stimulant use in ADHD treatment may cause increased cocaine cravings or use were not supported in a study of methylphenidate.
“Although there have been some concerns that stimulant use in the treatment of ADHD may cause increased cocaine cravings or use, this was not supported in a study of methylphenidate [121].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [121]
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References 63 · Cited by 249
- Authors
- Schubiner, H., Downey, K. K., Arfken, C. L., Johanson, C.-E., Schuster, C. R., Lockhart, N., Edwards, A., Donlin, J., & Pihlgren, E.
- Affiliations
- Wayne State University (US)
- Venue
- Experimental and Clinical Psychopharmacology
- Published
- 2002
- Volume
- 10
- Issue
- 3
- Pages
- 286-294
- ISSN
- 1064-1297 (ISSN-L)
- 1936-2293
- OpenAlex
- W1966490087
- Cited by
- 249
- References
- 63
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 6 · 2022: 4 · 2021: 10 · 2020: 8 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 7 · 2015: 13 · 2014: 11 · 2013: 15 · 2012: 22
- FWCI
- 6.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Experimental and Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1r01da010271-01)
- National Institute on Drug Abuse (R01 DA10271-03)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- methylphenidate, adult ADHD, cocaine dependence, comorbidities, cocaine use, cocaine craving
- MeSH terms
- Adolescent, Adult, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Double-Blind Method, Female, Humans, Male, Methylphenidate, Middle Aged, Pemoline, Psychiatric Status Rating Scales, Comorbidity, Cocaine-Related Disorders
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