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Randomized Controlled Trial
. 2013 Feb;44(2):224-30.
doi: 10.1016/j.jsat.2012.07.001. Epub 2012 Aug 11.

Predictors of treatment response in adolescents with comorbid substance use disorder and attention-deficit/hyperactivity disorder

Leanne Tamm  1 , Kathlene Trello-Rishel, Paula Riggs, Paul A Nakonezny, Michelle Acosta, Genie Bailey, Theresa Winhusen
Affiliations
Randomized Controlled Trial

Predictors of treatment response in adolescents with comorbid substance use disorder and attention-deficit/hyperactivity disorder

Leanne Tamm et al. J Subst Abuse Treat. 2013 Feb.

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) frequently co-occurs with substance use disorder (SUD) and is associated with poor substance-use treatment outcomes. A trial evaluating osmotic-release oral system methylphenidate (OROS-MPH) for adolescents with ADHD and SUD, concurrently receiving behavioral therapy, revealed inconsistent medication effects on ADHD or SUD. Clinical care for this population would be advanced by knowledge of treatment outcome predictors. Data from the randomized placebo-controlled trial (n = 299) were analyzed. Significant treatment predictors included: 1) Substance use severity, associated with poorer ADHD and SUD outcomes, 2) ADHD severity, associated with better ADHD and SUD outcomes, 3) comorbid conduct disorder, associated with poorer ADHD outcomes, and 4) court-mandated status, associated with better SUD outcomes but poorer treatment completion. An interaction effect showed that OROS-MPH improved SUD outcomes in adolescents with comorbid conduct disorder compared to placebo. While severe SUD may require more intensive psychosocial treatment, OROS-MPH may improve substance treatment outcomes in adolescents with co-morbid attention and conduct problems.

Trial registration: ClinicalTrials.gov NCT00264797.

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Figures

Figure 1
Figure 1
Significant Substance Use Severity X Treatment Interaction * = Significant difference between medication and placebo condition for participants with comorbid conduct disorder
See this image and copyright information in PMC

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