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

69 Scopus citations

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 1 2010

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ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Winhusen, T. M., Somoza, E. C., Brigham, G. S., Liu, D. S., Green, C. A., Covey, L. S., Croghan, I. T., Adler, L. A., Weiss, R. D., Leimberger, J. D., Lewis, D. F., & Dorer, E. M. (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, 71(12), 1680-1688. https://doi.org/10.4088/JCP.09m05089gry