Methylphenidate Treatment for Cocaine Abusers With Adult Attention-Deficit/Hyperactivity Disorder: A Pilot Study
J Clin Psychiatry 1998;59(6):300-305
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disorder (ADHD) is common among cocaine abusers seeking
treatment. This open trial was carried out to assess the efficacy
of sustained-release methylphenidate for the treatment of cocaine
abuse among individuals with ADHD.
Method: Twelve patients who met DSM-IV
diagnostic criteria for adult ADHD and cocaine dependence were
entered into a 12-week trial of divided daily doses of
sustained-release methylphenidate ranging from 40 to 80 mg. In
addition to the pharmacotherapy, patients also received
individual weekly relapse prevention therapy. Individuals were
assessed weekly for ADHD symptoms; vital signs and urine
toxicologies were obtained 3 times a week.
Results: Of the 12 patients entered, 10
completed at least 8 weeks of the study and 8 completed the
entire study. Using both a semistructured clinical interview and
a self-report assessment, patients reported reductions in
attention difficulties, hyperactivity, and impulsivity.
Self-reported cocaine use and craving decreased significantly.
More importantly, cocaine use, confirmed by urine toxicologies,
also decreased significantly.
Conclusion: These preliminary data suggest that
under close supervision, the combined intervention of
sustained-release methylphenidate and relapse prevention therapy
may be effective in treating individuals with both adult ADHD and