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Does Improvement in Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) Mediate an Effect of Long-Acting OROS-Methylphenidate on Cigarette Smoking? A Secondary Analysis of CTN-0029.

Poster presented at the NIDA Blending Conference, "Blending Addiction Science and Practice: Evidence-Based Treatment and Prevention in Diverse Populations and Settings," Albuquerque, NM, April 22-23, 2010.

Edward V. Nunes, MD (Columbia University College of Physicians and Surgeons, LI Node), Lirio S. Covey, PhD (Columbia University Medical Center, LI Node), Mei-Chen Hu, PhD (Columbia University, LI Node), Martina Pavlicova, PhD (Columbia University, LI Node), Eugene C. Somoza, MD, PhD (University of Cincinnati/CinARC, OV Node), Theresa M. Winhusen, PhD (University of Cincinnati/CinARC, OV Node).

Protocol CTN-0029 was a multisite, randomized, double-blind placebo-controlled trial of long-acting OROS-methylphenidate (OROS-MPH) for treatment of patients with both nicotine dependence and attention deficit hyperactivity disorder (ADHD). The principal outcome analysis found, as expected, a robust beneficial effect of OROS-MPH in improving symptoms of ADHD, but no clear effect of OROS-MPH on cigarette smoking outcomes. Since OROS-MPH is primarily a treatment for ADHD, it is reasonable to hypothesize that a beneficial effect on smoking outcome might occur only in those patients who experience a substantial improvement in their ADHD during treatment. This ancillary investigation used a linear model in which prolonged abstinence at week 10 (end of the acute treatment phase) was modeled as a function of medication treatment (OROS-MPH versus placebo), the change in the ADHD symptom severity score between baseline and end of study, and the interaction between ADHD improvement and treatment. The interaction was significant, suggesting that among those patients with the greatest improvement in ADHD symptoms during treatment, OROS-MPH was superior to placebo in promoting prolonged abstinence from nicotine. This secondary analysis suggests that OROS-MPH may be effective in promoting smoking cessation among the subset of patients whose ADHD response well to methylphenidate treatment. (Poster, PowerPoint slides, English, 2010)

Keywords: Attention Deficit Hyperactivity Disorder (ADHD) | Concerta | CTN primary outcomes | Nicotine replacement therapy | Osmotic-Release Methylphenidate (OROS-MPH) | Pharmacological therapy | Smoking | NIDA Blending Conference, 2010

Document No: 511

Submitted by Edward Nunes, PhD, lead author, 7/13/2010.

Covey, Lirio S. search mail
Hu, Mei-Chen search
Nunes, Edward V. search mail
Pavlicova, Martina search
Somoza, Eugene C. search mail
Winhusen, Theresa M. search mail
NIDA-CTN-0029 search www
Ohio Valley (Lead) search www
Greater New York (formerly Long Island and New York) search www
New England Consortium (formerly Northern New England) search www
Western States (formerly Oregon/Hawaii) search www

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