METHYLPHENIDATE TREATMENT FOR COCAINE ABUSE AND ADHD

哌醋甲酯治疗可卡因滥用和多动症

• 批准号: 2596880
• 负责人: Frances Rudnick Levin
• 金额: $ 24.32万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-04-20 至 2003-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2596880
• 关键词: adult human (21+); attention deficit disorder; clinical research; clinical trials; cocaine; comorbidity; drug abuse chemotherapy; drug addiction antagonist; human subject; human therapy evaluation; mental disorder chemotherapy; mental health epidemiology; methylphenidate; placebos; psychopharmacologic agent; slow release drug; substance abuse epidemiology

DESCRIPTION: (Applicant's Abstract) Studies targeting subgroups of cocaine abusers are needed because poor treatment outcome may, in part, be the result of comorbid psychiatric disorders. One subgroup that may benefit from targeted pharmacologic treatment is cocaine abusers who have adult attention-deficit hyperactivity disorder (ADHD). The prevalence of this disorder is substantially higher in treatment-seeking cocaine abusers (11%) than in the general population (1-3%). Given the comorbidity of ADHD and cocaine abuse, pharmacotherapies aimed at treating both disorders may be particularly effective. Methylphenidate (MPH), currently one of the most effective and safe treatments for childhood and adult ADHD, is a promising candidate. Individuals may be using cocaine to self-medicate their ADHD symptoms, due to an underlying dopamine deficit. Treating the underlying psychiatric disorder (ADHD) with MPH, may result in a reduction in cocaine use, as well as a reduction in ADHD symptoms. In the human laboratory we have shown that sustained-release MPH does not produce clinically significant cardiovascular changes, even during repeated dosing of cocaine. Further, a high maintenance dose of sustained-releaser MPH, unlike a low dose of sustained-release MPH, is more likely to reduce cocaine craving during repeated cocaine administration. Within the clinic setting, we have also shown that MPH is well-tolerated, not abused, and may be an effective treatment for cocaine abuse in adults with ADHD. Taken together, these findings suggest that double-blind, placebo-controlled trial to evaluate the effectiveness of sustained-release methylphenidate (MPH) is warranted. Specific Aims: 1) To determine if sustained-release MPH is more effective than placebo in reducing cocaine and other drug use in cocaine abusers with adult ADHD. 2) To determine if sustained-release MPH is more effective than placebo in reducing ADHD symptoms in cocaine abusers with adult ADHD. 3) To determine if improvement in ADHD symptoms precedes a reduction in cocaine use.

描述：（申请人摘要） 需要针对可卡因滥用者亚群进行研究，因为 治疗结果可能部分是共病精神疾病的结果 紊乱 一个亚组可能受益于靶向药理学 治疗对象是可卡因滥用者， ADHD（ADHD）。 这种疾病的患病率在以下国家高得多： 寻求治疗的可卡因滥用者（11%）高于一般人群 (1-3%). 考虑到ADHD和可卡因滥用的共病， 旨在治疗这两种疾病的药物可能特别有效。 哌醋甲酯（MPH），目前最有效和安全的 治疗儿童和成人多动症，是一个有前途的候选人。 个人可能会使用可卡因来自我抑制ADHD症状， 潜在的多巴胺缺乏症 治疗潜在的精神疾病 患有MPH的多动症（ADHD）也可能导致可卡因使用减少， ADHD症状的减轻。 在人类实验室中，我们已经证明， 缓释MPH不会产生临床显著的心血管 变化，甚至在可卡因重复给药期间。 此外，高 维持剂量的持续激光MPH，不像低剂量的 持续释放MPH，更有可能减少可卡因的渴望， 反复服用可卡因。 在诊所环境中，我们还 表明MPH耐受性良好，不滥用，可能是一种有效的 治疗成人ADHD可卡因滥用。 综上所述各项 研究结果表明，双盲，安慰剂对照试验，以评估 哌醋甲酯缓释片（MPH）的有效性得到保证。 具体目的：1）确定缓释MPH是否更有效 在减少可卡因滥用者的可卡因和其他药物使用方面， 成人多动症 2)为了确定缓释MPH是否比 安慰剂减少可卡因滥用者的ADHD症状成人ADHD。 3)到 确定ADHD症状的改善是否先于可卡因的减少 使用.