METHYLPHENIDATE TREATMENT FOR COCAINE ABUSE AND ADHD

描述：(申请人摘要) 需要针对可卡因滥用者亚群的研究，因为穷人 治疗结果可能在一定程度上是精神疾病并存的结果。 精神错乱。可能受益于靶向药物的一个亚群 治疗是有成人注意力缺陷多动的可卡因滥用者 精神障碍(ADHD)。这种疾病的患病率在 寻求治疗的可卡因滥用者(11%)高于普通人群 (1-3%)。鉴于ADHD和可卡因滥用的共病，药物治疗 针对这两种疾病的治疗可能特别有效。 哌醋甲酯(MPH)，目前是最有效和安全的药物之一 治疗儿童和成人ADHD，是一个很有前途的候选方案。 个人可能正在使用可卡因自我治疗他们的ADHD症状，由于 与潜在的多巴胺缺乏有关。治疗潜在的精神病患者 伴有公共卫生的多动症(ADHD)也可能导致可卡因使用量的减少 作为ADHD症状的减轻。在人体实验室中，我们已经证明 缓释mph不会在临床上产生明显的心血管疾病 即使在反复服用可卡因的过程中也会发生变化。更进一步，一个高位 维持剂量的缓释剂，不同于低剂量的 缓释每小时，更有可能减少可卡因的渴望在 反复吸食可卡因。在诊所环境中，我们也有 表明MPH耐受性良好，不被滥用，并且可能是一种有效的 成人ADHD患者滥用可卡因的治疗。这些加在一起， 研究结果表明，双盲、安慰剂对照试验评估 缓释哌醋甲酯(MPH)的有效性是有保证的。 具体目标：1)确定缓释mph是否更有效 在减少可卡因和其他药物使用方面优于安慰剂 成人多动症。2)确定缓释mph是否比 安慰剂在缓解成年ADHD可卡因滥用者ADHD症状中的作用。3)至 确定ADHD症状的改善是否先于可卡因的减少 使用。

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.