OROS-methylphenidate or placebo for adult smokers with attention deficit hyperactivity disorder: racial/ethnic differences.

Abstract

OBJECTIVE:

To explore racial/ethnic difference in OROS-methylphenidate (OMPH) efficacy when added to nicotine patch and counseling for treating nicotine dependence among smokers with attention deficit hyperactivity disorder (ADHD).

METHOD:

Participants were adult smokers with ADHD (202 whites and 51 non-whites) randomly assigned to OMPH or placebo in a multi-site, randomized controlled trial. Study outcomes were complete, prolonged, and point-prevalence abstinence at the end of treatment, and weekly ratings of ADHD symptoms, tobacco withdrawal symptoms, and desire to smoke.

RESULTS:

The rate of four-week complete abstinence (no slips or lapses) was significantly higher with OMPH than placebo among non-white (OMPH=42.9%, placebo=13.3%, chi(2)(1)=5.20, p=0.02) but not white participants (OMPH=23.1%, placebo=23.5%, chi(2)(1)=0.00, p=0.95). Patterns of prolonged and point-prevalence abstinence among non-whites were similar but fell short of statistical significance. OMPH reduced ADHD symptoms in both race/ethnic groups, and produced greater reductions in desire to smoke and withdrawal symptoms among the non-white than white participants. Change in desire to smoke, but not in withdrawal or ADHD symptoms predicted abstinence. The ability of OMPH to reduce desire to smoke among non-whites appeared to mediate the medication's positive effect on abstinence.

CONCLUSION:

Differential efficacy favoring non-whites of a medication for achieving smoking cessation is a potentially important finding that warrants further investigation. OROS-MPH could be an effective treatment for nicotine dependence among a subgroup of smokers.

• Authors: Lirio S Covey, Mei-Chen Hu, Theresa Winhusen, Judith Weissman, Ivan Berlin, Edward V Nunes
• Journal: Drug and alcohol dependence (Drug Alcohol Depend) Vol. 110 Issue 1-2 Pg. 156-9 (Jul 01 2010) ISSN: 1879-0046 [Electronic] Ireland
• PMID: 20219292 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Central Nervous System Stimulants
• Nicotinic Agonists
• Methylphenidate
• Nicotine

Topics

• Administration, Cutaneous
• Adult
• Attention Deficit Disorder with Hyperactivity (drug therapy, epidemiology, psychology)
• Behavior Therapy
• Central Nervous System Stimulants (administration & dosage, therapeutic use)
• Drug Therapy, Combination
• Ethnicity
• Female
• Forecasting
• Humans
• Male
• Methylphenidate (administration & dosage, therapeutic use)
• Nicotine (administration & dosage, therapeutic use)
• Nicotinic Agonists (administration & dosage, therapeutic use)
• Psychiatric Status Rating Scales
• Smoking (psychology, therapy)
• Smoking Cessation
• Substance Withdrawal Syndrome (prevention & control)
• Treatment Outcome