The Effect of Methylphenidate on Cognition in Patients with Comorbid Attention Deficit/Hyperactivity Disorder and Amphetamine Use Disorder: An Exploratory Single-Blinded within-Subject Study.
Christoffer Brynte, Maija Konstenius, Lotfi Khemiri, Amanda Bäcker, Joar Guterstam, Frances R Levin, Nitya Jayaram-Lindström, Johan Franck
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引用次数: 0
Abstract
Introduction: Attention deficit/hyperactivity disorder (ADHD) with co-occurring substance use disorder (SUD) is associated with poor treatment outcomes. Two randomized controlled trials, utilizing robust doses of stimulants, demonstrated a significant effect on treatment outcomes in patients with ADHD/SUD. This study aimed to investigate differences in executive functioning and explore the dose-dependent effect of OROS-methylphenidate (MPH) in patients with comorbid ADHD and amphetamine use disorder (ADHD+AMPH) and patients with ADHD only.
Methods: Three groups (ADHD+AMPH, ADHD only, and healthy controls) were assessed repeatedly with a neuropsychological test battery. An exploratory within-subject single-blinded design was employed where the ADHD only group received a maximum dose of 72 mg OROS-MPH, the ADHD+AMPH group a maximum dose of 180 mg, whereas the healthy subjects did not receive any study medication. Both ADHD groups received the same dose titration up to 72 mg OROS-MPH.
Results: The ADHD+AMPH group demonstrated a significantly poorer motor inhibition and spatial working memory and reported more severe ADHD symptoms compared to the ADHD only group. 180 mg OROS-MPH was associated with a significant improvement in executive functioning in the dual diagnosis group. However, the exploratory study design and recruitment issues do not allow for any conclusion to be drawn regarding the effect of 180 mg OROS-MPH.
Conclusion: Patients with ADHD+AMPH present with more severe neurocognitive deficits compared to ADHD only. The effect of 180 mg OROS-MPH on cognition in patients with ADHD+AMPH was inconclusive. Future studies should consider recruitment issues and high drop-out rates in this study population.
期刊介绍：
''European Addiction Research'' is a unique international scientific journal for the rapid publication of innovative research covering all aspects of addiction and related disorders. Representing an interdisciplinary forum for the exchange of recent data and expert opinion, it reflects the importance of a comprehensive approach to resolve the problems of substance abuse and addiction in Europe. Coverage ranges from clinical and research advances in the fields of psychiatry, biology, pharmacology and epidemiology to social, and legal implications of policy decisions. The goal is to facilitate open discussion among those interested in the scientific and clinical aspects of prevention, diagnosis and therapy as well as dealing with legal issues. An excellent range of original papers makes ‘European Addiction Research’ the forum of choice for all.
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