METHYLPHENIDATE TREATMENT FOR COCAINE ABUSERS WITH ADULT ATTENTION-DEFICIT HYPERACTIVITY DISORDER - A PILOT-STUDY/

Background: Attention-deficit/hyperactivity disorder (ADHD) is common among cocaine abusers seeking treatment. This open trial was carried o ut to assess the efficacy of sustained-release methylphenidate for the treatment of cocaine abuse among individuals with ADHD. Method: Twelv e patients who met DSM-IV diagnostic criteria for adult ADHD and cocai ne dependence were entered into a 12-week trial of divided daily doses of sustained-release methylphenidate ranging from 40 to 80 mg. In add ition 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 wee ks of the study and 8 completed the entire study. Using both a semistr uctured clinical interview and a self-report assessment, patients repo rted reductions in attention difficulties, hyperactivity, and impulsiv ity. Self-reported cocaine use and craving decreased significantly. Mo re importantly, cocaine use, confirmed by urine toxicologies, also dec reased significantly. Conclusion: These preliminary data suggest that under close supervision, the combined intervention of sustained-releas e methylphenidate and relapse prevention therapy may be effective in t reating individuals with both adult ADHD and cocaine dependence.