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Randomized Controlled Trial
. 2011 Oct;21(5):455-63.
doi: 10.1089/cap.2011.0014.

Subjective effects, misuse, and adverse effects of osmotic-release methylphenidate treatment in adolescent substance abusers with attention-deficit/hyperactivity disorder

Theresa M Winhusen  1 , Daniel F Lewis, Paula D Riggs, Robert D Davies, Lenard A Adler, Susan Sonne, Eugene C Somoza
Affiliations
Randomized Controlled Trial

Subjective effects, misuse, and adverse effects of osmotic-release methylphenidate treatment in adolescent substance abusers with attention-deficit/hyperactivity disorder

Theresa M Winhusen et al. J Child Adolesc Psychopharmacol. 2011 Oct.

Abstract

Objective: Psychostimulants are effective treatments for attention-deficit/hyperactivity disorder (ADHD) but may be associated with euphoric effects, misuse/diversion, and adverse effects. These risks are perceived by some clinicians to be greater in substance-abusing adolescents relative to non-substance-abusing adults. The present study evaluates the subjective effects, misuse/diversion, and adverse effects associated with the use of osmotic-release oral system methylphenidate (OROS-MPH), relative to placebo, for treating ADHD in adolescents with a substance use disorder (SUD) as a function of substance use severity and compared these risks with those associated with the treatment of ADHD in adults without a non-nicotine SUD.

Method: Datasets from two randomized placebo-controlled trials of OROS-MPH for treating ADHD, one conducted with 303 adolescents (13-18) with at least one non-nicotine SUD and one with 255 adult smokers (18-55), were analyzed. Outcome measures included the Massachusetts General Hospital Liking Scale, self-reported medication compliance, pill counts, and adverse events (AEs).

Results: Euphoric effects and misuse/diversion of OROS-MPH were not significantly affected by substance use severity. The euphoric effects of OROS-MPH did not significantly differ between the adolescent and adult samples. Adults rated OROS-MPH as more effective in treating ADHD, whereas adolescents reported feeling more depressed when taking OROS-MPH. The adolescents lost more pills relative to the adults regardless of treatment condition, which suggests the importance of careful medication monitoring. Higher baseline use of alcohol and cannabis was associated with an increased risk of experiencing a treatment-related AE in OROS-MPH, but baseline use did not increase the risk of serious AEs or of any particular category of AE and the adolescents did not experience more treatment-related AEs relative to the adults.

Conclusions: With good monitoring, and in the context of substance abuse treatment, OROS-MPH can be safely used in adolescents with an SUD despite non-abstinence.

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Figures

FIG. 1.
FIG. 1.
Mean Massachusetts General Hospital Liking Scale ratings as a function of treatment and study sample. †Significant study effect, p<0.05; ‡Significant treatment by study interaction, p<0.05. ADHD, attention-deficit/hyperactivity disorder; OROS-MPH, osmotic-release oral system methylphenidate.
See this image and copyright information in PMC

References

    1. American Psychiatric Association. DSM-IV. 4th. Washington, DC: American Psychiatric Association; 1994. Diagnostic and Statistical Manual of Mental Disorders.
    1. DuPaul GJ, editor; Power TJ, editor; Anastopoulos AD, editor; Reid R, editor. ADHD Rating Scale-IV: Checklists, Norms, Clinical Interpretation. New York: The Guilford Press; 1998.
    1. Faraone SV. Sergeant J. Gillberg C. Biederman J. The worldwide prevalence of ADHD: Is it an American condition? World Psychiatry. 2003;2:104–113. - PMC - PubMed
    1. Fredericks EM. Kollins SH. A pilot study of methylphenidate preference assessment in children diagnosed with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2005;15:729–741. - PubMed
    1. Fredericks EM. Kollins SH. Assessing methylphenidate preference in ADHD patients using a choice procedure. Psychopharmacology. 2004;175:391–398. - PubMed

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