Methylphenidate Treatment for Cocaine Abusers With Adult Attention-Deficit/Hyperactivity Disorder: A Pilot Study

Background: Attention-deficit/hyperactivitydisorder (ADHD) is common among cocaine abusers seekingtreatment. This open trial was carried out to assess the efficacyof sustained-release methylphenidate for the treatment of cocaineabuse among individuals with ADHD.

Method: Twelve patients who met DSM-IVdiagnostic criteria for adult ADHD and cocaine dependence wereentered into a 12-week trial of divided daily doses ofsustained-release methylphenidate ranging from 40 to 80 mg. Inaddition to the pharmacotherapy, patients also receivedindividual weekly relapse prevention therapy. Individuals wereassessed weekly for ADHD symptoms; vital signs and urinetoxicologies were obtained 3 times a week.

Results: Of the 12 patients entered, 10completed at least 8 weeks of the study and 8 completed theentire study. Using both a semistructured clinical interview anda self-report assessment, patients reported reductions inattention 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 thatunder close supervision, the combined intervention ofsustained-release methylphenidate and relapse prevention therapymay be effective in treating individuals with both adult ADHD andcocaine dependence.