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Bupropion for ADHD in Adolescents with Substance Use Disorders

安非他酮治疗患有药物使用障碍的青少年多动症

基本信息

批准号：
8278586
负责人：
Paula DeGraffenreid Riggs
金额：
$ 58.56万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-08-15 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8278586
关键词：
Abstinence Address Adolescent Adult Alcohol or Other Drugs use Area Attention deficit hyperactivity disorder Bupropion Cannabis Cannabis Abuse Clinical Cognitive Therapy Communities Comorbidity Complex Controlled Study Development Diagnostic and Statistical Manual Disease Dopamine Agonists Drug Use Disorder Drug abuse Drug usage Failure Frustration General Population High Prevalence Impairment Impulsivity Individual Intervention Light Marijuana Dependence Marijuana Smoking Mental Depression Mental Health Mental disorders Methamphetamine Methamphetamine dependence Modality Morbidity - disease rate National Institute of Drug Abuse Nicotine Nicotine Dependence Nicotine Withdrawal Nucleus Accumbens Outpatients Participant Pathological Gambling Pharmaceutical Preparations Pharmacotherapy Placebos Population Process Property Public Health Publishing Randomized Controlled Trials Reporting Research Research Design Safety Schools Severities Student Dropouts Substance Use Disorder Substance abuse problem Substance of Abuse Symptoms System Time Treatment outcome United States National Institutes of Health Ventral Tegmental Area Youth addiction adolescent substance abuse base control trial craving depressive symptoms dysphoria effective therapy expectation mortality neurotoxicity nicotine craving outcome forecast protective effect psychosocial randomized placebo controlled trial research and development response smoking cessation treatment program

项目摘要

DESCRIPTION (provided by applicant): This application is a revised resubmission of R01 DA022284, initially reviewed by NIDA-L in June 2006. The application proposes a randomized, placebo-controlled trial of bupropion + cognitive behavioral therapy (CBT) to evaluate the efficacy of this combined therapy for attention deficit hyperactivity disorder (ADHD) in adolescents in whom these disorders commonly co-occur. ADHD is one of the most common co-occurring psychiatric disorders (30-50%) in adolescents with substance use disorders (SUD) and has been associated with more severe drug abuse, school failure, long-term psychosocial impairment, and poorer substance treatment outcomes. Research has shown that bupropion is a safe and effective treatment for both ADHD and nicotine dependence in individuals without SUD, and newer research provides empirical support for its unique pharmacotherapeutic properties and potential for treating other addictive disorders (e.g., methamphetamine dependence, pathological gambling). No controlled studies have yet evaluated bupropion's safety and efficacy for ADHD and SUD (including nicotine and cannabis) in adolescents. The lack of research on the safety and efficacy of medications in adolescents with SUD and psychiatric comorbidities contributes to a serious lack of integrated treatment for commonly co-occurring mental health and substance problems in community-based adolescent drug treatment programs. This then contributes to poorer treatment outcomes and prognosis for the large number of comorbid youths with substance abuse and mental health problems that significantly impact public health. The specific aims of the proposed study will address this research gap by conducting a 16-week randomized controlled trial of bupropion vs. placebo to evaluate the safety and efficacy of this low abuse potential medication on ADHD, nicotine dependence, and cannabis use disorders (not excluding other SUD) in 130 adolescents (13-19) receiving concurrent outpatient substance treatment (CBT). The study design and analytic approach will enable assessment of the complex inter-relationship between change in ADHD, depression/dysphoria (and other psychiatric symptoms) and change in nicotine, cannabis and other substance use within and between treatment groups. Thus, the application addresses important research gaps in at least two priority areas of the NIDA/NIH research agenda: 1) research on effective treatments for adolescents with addiction and psychiatric comorbidity, and 2) medications development research for nicotine and cannabis use disorders in adolescents.

描述(申请人提供)：本申请是由NIDA-L于2006年6月首次审查的R01DA022284的修订后的重新提交。该申请提出了一项安慰剂对照的随机试验，即安非他酮+认知行为疗法(CBT)，以评估这种联合疗法对青少年注意缺陷多动障碍(ADHD)的疗效，这些疾病通常是这些疾病共同发生的。ADHD是患有物质使用障碍(SUD)的青少年中最常见的共生精神障碍之一(30%-50%)，并与更严重的药物滥用、学业失败、长期心理社会障碍和较差的药物治疗结果有关。研究表明，安非他酮是一种安全有效的治疗ADHD和尼古丁依赖的药物，新的研究为其独特的药物治疗特性和治疗其他成瘾疾病(如甲基苯丙胺依赖、病理性赌博)的潜力提供了经验支持。目前还没有对照研究评估安非他酮治疗青少年ADHD和SUD(包括尼古丁和大麻)的安全性和有效性。缺乏对患有SUD和精神疾病共病的青少年用药的安全性和有效性的研究，导致社区青少年药物治疗计划中严重缺乏对常见的共生心理健康和物质问题的综合治疗。这导致大量患有严重影响公共健康的药物滥用和精神健康问题的青少年的治疗结果和预后较差。这项拟议研究的具体目标将通过进行为期16周的安非他酮与安慰剂的随机对照试验来填补这一研究空白，以评估这种低滥用潜力药物在130名同时接受门诊药物治疗(CBT)的青少年(13-19岁)中治疗ADHD、尼古丁依赖和大麻使用障碍(不包括其他SUD)的安全性和有效性。研究设计和分析方法将能够评估治疗组内和治疗组之间ADHD、抑郁/焦虑症(和其他精神症状)的变化与尼古丁、大麻和其他物质使用的变化之间的复杂相互关系。因此，该申请填补了NIDA/NIH研究议程至少两个优先领域的重要研究空白：1)对患有成瘾和精神疾病的青少年进行有效治疗的研究，以及2)针对青少年尼古丁和大麻使用障碍的药物开发研究。