Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment on Smoking Cessation Intervention in ADHD Smokers

• DOI: 10.4088/jcp.09m05089gry
• Publication Date: 2010-05-25T23:06:35Z
• Authors: Theresa M. Winhusen; Eugene C. Somoza; Gregory S. Brigham; David S. Liu; Carla A. Green; Lirio S. Covey; Ivana T. Croghan; Lenard A. Adler; Roger D. Weiss; Jeffrey D. Leimbe...; Daniel F. Lewis; Emily M. Dorer
• Keywords: Adult; Counseling; Male; Nicotine; Dose-Response Relationship, Drug; Smoking; Administration, Oral; Middle Aged; Combined Modality Therapy; 3. Good health; Diagnostic and Statistical Manual of Mental Disorders; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Double-Blind Method; Attention Deficit Disorder with Hyperactivity; Delayed-Action Preparations; Methylphenidate; Humans; Central Nervous System Stimulants; Female; Smoking Cessation; Follow-Up Studies

High smoking rates in adults with attention-deficit/hyperactivity disorder (ADHD) and nicotine's amelioration of ADHD suggest that effective ADHD treatment might facilitate abstinence in smokers with ADHD. The present study evaluated if using osmotic-release oral system methylphenidate (OROS-MPH) to treat ADHD enhances response to smoking cessation treatment in smokers with ADHD.A randomized, double-blind, placebo-controlled, 11-week trial with a 1-month follow-up was conducted at 6 clinical sites between December 2005 and January 2008. Adults (aged 18-55 years) meeting DSM-IV criteria for ADHD and interested in quitting smoking were randomly assigned to OROS-MPH titrated to 72 mg/d (n = 127) or placebo (n = 128). All participants received brief weekly individual smoking cessation counseling for 11 weeks and 21 mg/d nicotine patches starting on the smoking quit day (day 27) through study week 11. Outcome measures included prolonged smoking abstinence and DSM-IV ADHD Rating Scale (ADHD-RS) score.Of 255 randomly assigned participants, 204 (80%) completed the trial. Prolonged abstinence rates, 43.3% and 42.2%, for the OROS-MPH and placebo groups, respectively, did not differ significantly (OR = 1.1; 95% CI, 0.63-1.79; P = .81). Relative to placebo, OROS-MPH evidenced a greater reduction in DSM-IV ADHD-RS score (P < .0001) and in cigarettes per day during the post-quit phase (P = .016). Relative to placebo, OROS-MPH increased blood pressure and heart rate to a statistically, but not clinically, significant degree (P < .05); medication discontinuation did not differ significantly between treatments.Treatment for ADHD did not improve smoking cessation success; OROS-MPH, relative to placebo, effectively treated ADHD and was safe and generally well tolerated in this healthy sample of adult ADHD smokers.clinical trials.gov Identifier: NCT00253747.