Journal of Substance Abuse Treatment 2015;59:104-108. [doi: 10.1016/j.jsat.2015.07.004]
Lirio S. Covey, PhD (Columbia University Medical Center, GNY Node), Mei-Chen Hu, PhD (Columbia University Medical Center, GNY Node), Theresa M. Winhusen, PhD (University of Cincinnati College of Medicine, OV Node), Jennifer Lima, MPH (Columbia University Medical Center, GNY Node), Ivan Berlin, MD, PhD (Hôpital Pitié-Salêtrière-
Université P and M Curie, France), Edward V. Nunes, MD (Columbia University Medical Center, GNY Node).
A preponderance of relevant research has indicated reduction in anxiety and depressive symptoms following smoking abstinence. This secondary analysis of data from the National Drug Abuse Treatment Clinical Trials Network study CTN-0029 investigated whether the phenomenon extends to smokers with attention deficit hyperactivity disorder (ADHD). The study setting was an 11-week double-blind placebo-controlled randomized trial of osmotic release oral system methylphenidate (OROS-MPH) as a cessation aid when added to nicotine patch and counseling. Participants were 255 adult smokers with ADHD. The study outcomes were: anxiety (measured by the Beck Anxiety Inventory (BAD)) and depressed mood (Beck Depression Inventory II (BDI)), measured 1 week and 6 weeks after a target quit day (TQD). The main predictor was point-prevalence abstinence measured at weeks 1 and 6 after TQD. Covariates were treatment (OROS-MPH vs. placebo), past major depression, past anxiety disorder, number of cigarettes smoked daily, demographics (age, gender, education, marital status) and baseline scores on the BAI, BDI, and DSM-IV ADHD Rating Scale.
Results found that abstinence was significantly associated with lower anxiety ratings throughout the post-quit period (p<0.001). Depressed mood was lower for abstainers than non-abstainers at week 1 (p<0.05), but no longer at week 6 (p=0.83). Treatment with OROS-MPH relative to placebo showed significant reductions at week 6 after TQD for both anxiety (p<0.05) and depressed mood (p<0.001), but not at week 1. Differential abstinence effects of gender were observed. Anxiety and depression ratings at baseline predicted increased ratings of corresponding measures during the post-quit period.
Conclusions: Stopping smoking yielded reductions in anxiety and depressed mood in smokers with ADHD treated with nicotine patch and counseling. Treatment with OROS-MPH produced better outcomes on the post-cessation mood ratings compared to placebo, albeit in a delayed manner, suggesting that OROS-MPH could be an important adjunct for achieving smoking abstinence in this population. Validation of findings from this secondary analysis could advance discovery and development of treatments for persons dually diagnosed with nicotine dependence and ADHD. (Article (Peer-Reviewed), PDF, English, 2015)
Keywords: Anxiety disorders | Attention Deficit Hyperactivity Disorder (ADHD) | Co-occurring disorders | CTN platform/ancillary study | Depression | Osmotic-Release Methylphenidate (OROS-MPH) | Pharmacological therapy | Journal of Substance Abuse Treatment (journal)
Document No: 1163, PMID: 25456093., PMCID: PMC4661105.
Submitted by CTN Dissemination Librarians, 7/22/2015.