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Randomized Controlled Trial
. 2012 Aug 1;124(3):268-73.
doi: 10.1016/j.drugalcdep.2012.01.019. Epub 2012 Feb 23.

Attention-deficit/hyperactivity disorder (ADHD) symptoms, craving to smoke, and tobacco withdrawal symptoms in adult smokers with ADHD

Ivan Berlin  1 , Mei-Chen Hu, Lirio S Covey, Theresa Winhusen
Affiliations
Randomized Controlled Trial

Attention-deficit/hyperactivity disorder (ADHD) symptoms, craving to smoke, and tobacco withdrawal symptoms in adult smokers with ADHD

Ivan Berlin et al. Drug Alcohol Depend. .

Abstract

Background: Tobacco withdrawal symptoms may be confounded with attention-deficit/hyperactivity disorder (ADHD) symptoms among smokers with ADHD.

Objective: (1) To assess overlap between ADHD symptoms and tobacco/nicotine withdrawal symptoms and craving; (2) to assess the relationship between craving or withdrawal symptoms and the effect of osmotic-release oral system methylphenidate (OROS-MPH) on ADHD symptoms; (3) to assess the association of ADHD symptoms, craving, and withdrawal symptoms with abstinence.

Methods: Secondary analysis of a randomized, placebo controlled smoking cessation trial assessing the efficacy of OROS-MPH taken in addition to nicotine patch among individuals with ADHD. ADHD symptoms, withdrawal symptoms, and craving were assessed at baseline and 2, 4 and 6 weeks after a target quit day.

Results: Withdrawal symptoms and craving showed limited and modest overlap with ADHD symptoms prior to abstinence but more extensive and stronger correlation after quit day. Compared to placebo, OROS-MPH reduced ADHD symptoms; this effect was attenuated by controlling for withdrawal symptoms, but not by craving. Craving, but not ADHD symptoms and withdrawal symptoms, was associated with abstinence during the trial.

Conclusion: When treating smokers with ADHD (1) craving, rather than tobacco withdrawal symptoms or ADHD symptoms may be the more effective therapeutic smoking cessation targets; (2) careful distinction of craving, withdrawal symptoms, and ADHD symptoms when assessing withdrawal phenomena is needed.

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Conflict of interest statement

Conflict of interest

Ivan Berlin received honoraria for advisory roles with Sanofi-Aventis and Pfizer, Inc. in the last 5 years. Lirio S. Covey received research support in 2009 from Pfizer, Inc. The other co-authors report no conflict of interest.

References

    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition, Text Revision. Washington DC: American Psychiatric Association; 2000.
    1. Adler L, Cohen J. Diagnosis and evaluation of adults with attention-deficit/ hyperactivitydisorder. Psychiatr. Clin. N. Am. 2004;27:187–201. - PubMed
    1. Berlin I, Jacob N, Coudert M, Perriot J, Schultz L, Rodon N. Adjustment of nicotine replacement therapies according to saliva cotinine concentration: the ADONIS trial. A randomized study in smokers with medical comorbidities. Addiction. 2011;106:833–843. - PubMed
    1. Conners CK, Levin ED, Sparrow E, Hinton SC, Erhardt D, Meck WH, Rose JE, March J. Nicotine and attention in adult attention deficit hyperactivity disorder (ADHD) Psychopharmacol. Bull. 1996;32:67–73. - PubMed
    1. Covey LS, Manubay J, Jiang H, Nortick M, Palumbo D. Smoking cessation and inattention or hyperactivity/impulsivity: a post hoc analysis. Nicotine Tob. Res. 2008;10:1717–1725. - PMC - PubMed

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