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Exploring Longitudinal Course and Treatment-Baseline Severity Interactions in Secondary Outcomes of Smoking Cessation Treatment in Individuals with Attention-Deficit Hyperactivity Disorder.

American Journal of Drug and Alcohol Abuse 2018 (in press). [doi: 10.1080/00952990.2017.1416474]

Sean X. Luo, MD, PhD, Melanie Wall, PhD, Lirio S. Covey, PhD, Mei-Chen Hu, PhD, Jennifer M. Scodes, MS, Frances R. Levin, MD, Edward V. Nunes, MD (all from Columbia Univerisity, GNY Node), Theresa M. Winhusen, PhD (University of Cincinnati, OV Node).

A double blind, placebo-controlled randomized trial evaluation osmotic-release oral system methylphenidate (OROS-MPH) for smoking cessation revealed a significant interaction effect in which participants with higher baseline ADHD severity had better abstinence outcomes with OROS-MPH while participants with lower baseline ADHD severity had worse outcomes (CTN-0029). This study examined secondary outcomes that might bear on the mechanism for this differential effect treatment effect. Longitudinal analyses were conducted to evaluate the effect of OROS-MPH on three secondary outcomes (ADHD symptom severity, nicotine craving, and withdrawal) in the total sample (N=255, 56% male) and in the high (N=134) and low (N=121) baseline ADHD severity groups.

Results found that OROS-MPH significantly improved ADHD symptoms and nicotine withdrawal symptoms in the total sample, and exploratory analyses showed that in both higher and lower baseline severity groups, OROS-MPH statistically significantly improved these two outcomes. No effect on craving overall was detected, though exploratory analyses showed statistically significantly decreased craving in the high ADHD severity participants on OROS-MPH. No treatment by ADHD baseline severity interaction was detected for the outcomes.

Conclusions: Methylphenidate improved secondary outcomes during smoking cessation independent of baseline ADHD severity, with no evident treatment-baseline severity interaction. Results suggest divergent responses to smoking cessation treatment in the higher and lower severity groups cannot be explained by concordant divergence in craving, withdrawal, and ADHD symptoms severity, and alternative hypotheses may need to be identified. (Article (Peer-Reviewed), PDF, English, 2018)

Keywords: Attention Deficit Hyperactivity Disorder (ADHD) | Craving | CTN platform/ancillary study | Osmotic-Release Methylphenidate (OROS-MPH) | Smoking | Smoking cessation | American Journal of Drug and Alcohol Abuse (journal)

Document No: 1300, PMID: 29370538, PMCID: PMC6060016 (available 7/25/2019).

Submitted by CTN Dissemination Librarians, 1/30/2018.


Covey, Lirio S. mail
Hu, Mei-Chen
Levin, Frances R. mail
Luo, Sean X.
Nunes, Edward V. mail
Scodes, Jennifer M. search
Wall, Melanie
Winhusen, Theresa M. search mail
NIDA-CTN-0029 www
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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
Updated 8/2018 --
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