Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) treatment on smoking cessation intervention in ADHD smokers

A randomized, double-blind, placebo-controlled trial

Theresa M. Winhusen, Eugene C. Somoza, Gregory S. Brigham, David S. Liu, Carla A. Green, Lirio S. Covey, Ivana T Croghan, Lenard A. Adler, Roger D. Weiss, Jeffrey D. Leimberger, Daniel F. Lewis, Emily M. Dorer

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Objective: High smoking rates in adults with attention-deficit/ hyperactivity disorder (ADHD) and nicotine's amelioration of ADHD suggest that effective ADHD treatment might facilitate abstinence in smokers with ADHD. The present study evaluated if using osmotic-release oral system methylphenidate (OROS-MPH) to treat ADHD enhances response to smoking cessation treatment in smokers with ADHD. Method: A randomized, double-blind, placebocontrolled, 11-week trial with a 1-month follow-up was conducted at 6 clinical sites between December 2005 and January 2008. Adults (aged 18-55 years) meeting DSM-IV criteria for ADHD and interested in quitting smoking were randomly assigned to OROS-MPH titrated to 72 mg/d (n = 127) or placebo (n = 128). All participants received brief weekly individual smoking cessation counseling for 11 weeks and 21 mg/d nicotine patches starting on the smoking quit day (day 27) through study week 11. Outcome measures included prolonged smoking abstinence and DSM-IV ADHD Rating Scale (ADHD-RS) score. Results: Of 255 randomly assigned participants, 204 (80%) completed the trial. Prolonged abstinence rates, 43.3% and 42.2%, for the OROS-MPH and placebo groups, respectively, did not differ significantly (OR = 1.1; 95% CI, 0.63-1.79; P = .81). Relative to placebo, OROS-MPH evidenced a greater reduction in DSM-IV ADHD-RS score (P < .0001) and in cigarettes per day during the post-quit phase (P = .016). Relative to placebo, OROS-MPH increased blood pressure and heart rate to a statistically, but not clinically, significant degree (P < .05); medication discontinuation did not differ significantly between treatments. Conclusions: Treatment for ADHD did not improve smoking cessation success; OROS-MPH, relative to placebo, effectively treated ADHD and was safe and generally well tolerated in this healthy sample of adult ADHD smokers. Trial Registration: clinical trials.gov Identifier: NCT00253747.

Original languageEnglish (US)
Pages (from-to)1680-1688
Number of pages9
JournalJournal of Clinical Psychiatry
Volume71
Issue number12
DOIs
StatePublished - Dec 2010

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Smoking Cessation
Attention Deficit Disorder with Hyperactivity
Placebos
Methylphenidate
Therapeutics
Smoking
Diagnostic and Statistical Manual of Mental Disorders
Tobacco Use Cessation Products
Withholding Treatment
Nicotine
Tobacco Products
Counseling
Heart Rate
Outcome Assessment (Health Care)
Clinical Trials
Blood Pressure

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) treatment on smoking cessation intervention in ADHD smokers : A randomized, double-blind, placebo-controlled trial. / Winhusen, Theresa M.; Somoza, Eugene C.; Brigham, Gregory S.; Liu, David S.; Green, Carla A.; Covey, Lirio S.; Croghan, Ivana T; Adler, Lenard A.; Weiss, Roger D.; Leimberger, Jeffrey D.; Lewis, Daniel F.; Dorer, Emily M.

In: Journal of Clinical Psychiatry, Vol. 71, No. 12, 12.2010, p. 1680-1688.

Research output: Contribution to journalArticle

Winhusen, TM, Somoza, EC, Brigham, GS, Liu, DS, Green, CA, Covey, LS, Croghan, IT, Adler, LA, Weiss, RD, Leimberger, JD, Lewis, DF & Dorer, EM 2010, 'Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) treatment on smoking cessation intervention in ADHD smokers: A randomized, double-blind, placebo-controlled trial', Journal of Clinical Psychiatry, vol. 71, no. 12, pp. 1680-1688. https://doi.org/10.4088/JCP.09m05089gry
Winhusen, Theresa M. ; Somoza, Eugene C. ; Brigham, Gregory S. ; Liu, David S. ; Green, Carla A. ; Covey, Lirio S. ; Croghan, Ivana T ; Adler, Lenard A. ; Weiss, Roger D. ; Leimberger, Jeffrey D. ; Lewis, Daniel F. ; Dorer, Emily M. / Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) treatment on smoking cessation intervention in ADHD smokers : A randomized, double-blind, placebo-controlled trial. In: Journal of Clinical Psychiatry. 2010 ; Vol. 71, No. 12. pp. 1680-1688.
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title = "Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) treatment on smoking cessation intervention in ADHD smokers: A randomized, double-blind, placebo-controlled trial",
abstract = "Objective: High smoking rates in adults with attention-deficit/ hyperactivity disorder (ADHD) and nicotine's amelioration of ADHD suggest that effective ADHD treatment might facilitate abstinence in smokers with ADHD. The present study evaluated if using osmotic-release oral system methylphenidate (OROS-MPH) to treat ADHD enhances response to smoking cessation treatment in smokers with ADHD. Method: A randomized, double-blind, placebocontrolled, 11-week trial with a 1-month follow-up was conducted at 6 clinical sites between December 2005 and January 2008. Adults (aged 18-55 years) meeting DSM-IV criteria for ADHD and interested in quitting smoking were randomly assigned to OROS-MPH titrated to 72 mg/d (n = 127) or placebo (n = 128). All participants received brief weekly individual smoking cessation counseling for 11 weeks and 21 mg/d nicotine patches starting on the smoking quit day (day 27) through study week 11. Outcome measures included prolonged smoking abstinence and DSM-IV ADHD Rating Scale (ADHD-RS) score. Results: Of 255 randomly assigned participants, 204 (80{\%}) completed the trial. Prolonged abstinence rates, 43.3{\%} and 42.2{\%}, for the OROS-MPH and placebo groups, respectively, did not differ significantly (OR = 1.1; 95{\%} CI, 0.63-1.79; P = .81). Relative to placebo, OROS-MPH evidenced a greater reduction in DSM-IV ADHD-RS score (P < .0001) and in cigarettes per day during the post-quit phase (P = .016). Relative to placebo, OROS-MPH increased blood pressure and heart rate to a statistically, but not clinically, significant degree (P < .05); medication discontinuation did not differ significantly between treatments. Conclusions: Treatment for ADHD did not improve smoking cessation success; OROS-MPH, relative to placebo, effectively treated ADHD and was safe and generally well tolerated in this healthy sample of adult ADHD smokers. Trial Registration: clinical trials.gov Identifier: NCT00253747.",
author = "Winhusen, {Theresa M.} and Somoza, {Eugene C.} and Brigham, {Gregory S.} and Liu, {David S.} and Green, {Carla A.} and Covey, {Lirio S.} and Croghan, {Ivana T} and Adler, {Lenard A.} and Weiss, {Roger D.} and Leimberger, {Jeffrey D.} and Lewis, {Daniel F.} and Dorer, {Emily M.}",
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T1 - Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) treatment on smoking cessation intervention in ADHD smokers

T2 - A randomized, double-blind, placebo-controlled trial

AU - Winhusen, Theresa M.

AU - Somoza, Eugene C.

AU - Brigham, Gregory S.

AU - Liu, David S.

AU - Green, Carla A.

AU - Covey, Lirio S.

AU - Croghan, Ivana T

AU - Adler, Lenard A.

AU - Weiss, Roger D.

AU - Leimberger, Jeffrey D.

AU - Lewis, Daniel F.

AU - Dorer, Emily M.

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N2 - Objective: High smoking rates in adults with attention-deficit/ hyperactivity disorder (ADHD) and nicotine's amelioration of ADHD suggest that effective ADHD treatment might facilitate abstinence in smokers with ADHD. The present study evaluated if using osmotic-release oral system methylphenidate (OROS-MPH) to treat ADHD enhances response to smoking cessation treatment in smokers with ADHD. Method: A randomized, double-blind, placebocontrolled, 11-week trial with a 1-month follow-up was conducted at 6 clinical sites between December 2005 and January 2008. Adults (aged 18-55 years) meeting DSM-IV criteria for ADHD and interested in quitting smoking were randomly assigned to OROS-MPH titrated to 72 mg/d (n = 127) or placebo (n = 128). All participants received brief weekly individual smoking cessation counseling for 11 weeks and 21 mg/d nicotine patches starting on the smoking quit day (day 27) through study week 11. Outcome measures included prolonged smoking abstinence and DSM-IV ADHD Rating Scale (ADHD-RS) score. Results: Of 255 randomly assigned participants, 204 (80%) completed the trial. Prolonged abstinence rates, 43.3% and 42.2%, for the OROS-MPH and placebo groups, respectively, did not differ significantly (OR = 1.1; 95% CI, 0.63-1.79; P = .81). Relative to placebo, OROS-MPH evidenced a greater reduction in DSM-IV ADHD-RS score (P < .0001) and in cigarettes per day during the post-quit phase (P = .016). Relative to placebo, OROS-MPH increased blood pressure and heart rate to a statistically, but not clinically, significant degree (P < .05); medication discontinuation did not differ significantly between treatments. Conclusions: Treatment for ADHD did not improve smoking cessation success; OROS-MPH, relative to placebo, effectively treated ADHD and was safe and generally well tolerated in this healthy sample of adult ADHD smokers. Trial Registration: clinical trials.gov Identifier: NCT00253747.

AB - Objective: High smoking rates in adults with attention-deficit/ hyperactivity disorder (ADHD) and nicotine's amelioration of ADHD suggest that effective ADHD treatment might facilitate abstinence in smokers with ADHD. The present study evaluated if using osmotic-release oral system methylphenidate (OROS-MPH) to treat ADHD enhances response to smoking cessation treatment in smokers with ADHD. Method: A randomized, double-blind, placebocontrolled, 11-week trial with a 1-month follow-up was conducted at 6 clinical sites between December 2005 and January 2008. Adults (aged 18-55 years) meeting DSM-IV criteria for ADHD and interested in quitting smoking were randomly assigned to OROS-MPH titrated to 72 mg/d (n = 127) or placebo (n = 128). All participants received brief weekly individual smoking cessation counseling for 11 weeks and 21 mg/d nicotine patches starting on the smoking quit day (day 27) through study week 11. Outcome measures included prolonged smoking abstinence and DSM-IV ADHD Rating Scale (ADHD-RS) score. Results: Of 255 randomly assigned participants, 204 (80%) completed the trial. Prolonged abstinence rates, 43.3% and 42.2%, for the OROS-MPH and placebo groups, respectively, did not differ significantly (OR = 1.1; 95% CI, 0.63-1.79; P = .81). Relative to placebo, OROS-MPH evidenced a greater reduction in DSM-IV ADHD-RS score (P < .0001) and in cigarettes per day during the post-quit phase (P = .016). Relative to placebo, OROS-MPH increased blood pressure and heart rate to a statistically, but not clinically, significant degree (P < .05); medication discontinuation did not differ significantly between treatments. Conclusions: Treatment for ADHD did not improve smoking cessation success; OROS-MPH, relative to placebo, effectively treated ADHD and was safe and generally well tolerated in this healthy sample of adult ADHD smokers. Trial Registration: clinical trials.gov Identifier: NCT00253747.

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