Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopment disorder occurring during childhood. However, ADHD persists into adulthood in 45.7% of cases. The global prevalence of adult ADHD is estimated to 5.3%, with no difference between Europe and North America. ADHD is often comorbid with substance use disorder (SUD), with Odds Ratio ranges from 1.5 to 7.9, depending on the substance and the dependence level. Conversely, the prevalence of ADHD among patients with SUD is 10.8%, versus 3.8% for patients without SUD.
Methylphenidate (MPH) alleviates ADHD symptoms and, as such, is currently considered as a first choice medication. MPH blocks the dopamine and norepinephrine transporters leading to an increase in extracellular dopamine. It should be noted that its subjective effects are highly dependent on the pharmacokinetic and especially on the rate of input, which highlights the importance of choosing a sustainedrelease formulation. Meanwhile, prescribing MPH to patients with comorbid SUD has always been challenging for clinicians.
The aim of this review is to address the benefits and pitfalls of using MPH in adults with ADHD comorbid SUD, depending on each of the following types of SUD: amphetamine, cocaine, nicotine, alcohol, cannabis and opiates. Overall, due to the prevalence of ADHD in SUD and to the benefits of MPH observed in this population, and considering the mild or low side effects observed, the response to MPH treatment should be evaluated individually in adults with comorbid ADHD and SUD. The choice of the formulation should favor sustained- release MPH over immediate release MPH. Cardiovascular parameters also have to be monitored during long-term use.
Keywords: Addiction, alcohol, amphetamine, ADHD, cocaine, methylphenidate, nicotine, substance use disorder.
Current Pharmaceutical Design
Title:Methylphenidate in Adults with Attention Deficit Hyperactivity Disorder and Substance Use Disorders
Volume: 21 Issue: 23
Author(s): Nicolas Simon, Benjamin Rolland and Laurent Karila
Affiliation:
Keywords: Addiction, alcohol, amphetamine, ADHD, cocaine, methylphenidate, nicotine, substance use disorder.
Abstract: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopment disorder occurring during childhood. However, ADHD persists into adulthood in 45.7% of cases. The global prevalence of adult ADHD is estimated to 5.3%, with no difference between Europe and North America. ADHD is often comorbid with substance use disorder (SUD), with Odds Ratio ranges from 1.5 to 7.9, depending on the substance and the dependence level. Conversely, the prevalence of ADHD among patients with SUD is 10.8%, versus 3.8% for patients without SUD.
Methylphenidate (MPH) alleviates ADHD symptoms and, as such, is currently considered as a first choice medication. MPH blocks the dopamine and norepinephrine transporters leading to an increase in extracellular dopamine. It should be noted that its subjective effects are highly dependent on the pharmacokinetic and especially on the rate of input, which highlights the importance of choosing a sustainedrelease formulation. Meanwhile, prescribing MPH to patients with comorbid SUD has always been challenging for clinicians.
The aim of this review is to address the benefits and pitfalls of using MPH in adults with ADHD comorbid SUD, depending on each of the following types of SUD: amphetamine, cocaine, nicotine, alcohol, cannabis and opiates. Overall, due to the prevalence of ADHD in SUD and to the benefits of MPH observed in this population, and considering the mild or low side effects observed, the response to MPH treatment should be evaluated individually in adults with comorbid ADHD and SUD. The choice of the formulation should favor sustained- release MPH over immediate release MPH. Cardiovascular parameters also have to be monitored during long-term use.
Export Options
About this article
Cite this article as:
Simon Nicolas, Rolland Benjamin and Karila Laurent, Methylphenidate in Adults with Attention Deficit Hyperactivity Disorder and Substance Use Disorders, Current Pharmaceutical Design 2015; 21 (23) . https://dx.doi.org/10.2174/1381612821666150619093254
DOI https://dx.doi.org/10.2174/1381612821666150619093254 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
Blood-based biomarkers in large-scale screening for neurodegenerative diseases
Disease biomarkers are necessary tools that can be employ in several clinical context of use (COU), ranging from the (early) diagnosis, prognosis, prediction, to monitor of disease state and/or drug efficacy. Regarding neurodegenerative diseases, in particular Alzheimer’s disease (AD), a battery of well-validated biomarkers are available, such as cerebrospinal fluid ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Diabetes mellitus: advances in diagnosis and treatment driving by precision medicine
Diabetes mellitus (DM) is a chronic degenerative metabolic disease with ever increasing prevalence worldwide which is now an epidemic disease affecting 500 million people worldwide. Insufficient insulin secretion from pancreatic β cells unable to maintain blood glucose homeostasis is the main feature of this disease. Multifactorial and complex nature of ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Association between NADPH Oxidase 2 (NOX2) and Drug Resistance in Cancer
Current Cancer Drug Targets Eplerenone, a New Selective Aldosterone Blocker
Current Pharmaceutical Design Ankylosing Spondylitis and Risk of Cardiac Arrhythmia and Conduction Disorders: A Systematic Review and Meta-analysis
Current Cardiology Reviews Physiological and Pharmacological Insights into the Role of Ionic Channels in Cardiac Pacemaker Activity
Cardiovascular & Hematological Disorders-Drug Targets Bronchial Thermoplasty: Burn to Cure?
Current Respiratory Medicine Reviews Lipoprotein (a) and Cardiovascular Risk: The Show Must go on
Current Medicinal Chemistry SIRT1 as a Therapeutic Target in Diabetic Complications
Current Medicinal Chemistry Introduction (Transient Receptor Potential TRP Channels as Therapeutic Drug Targets: Next Round!)
Current Topics in Medicinal Chemistry Pediatrics for Disability: A Comprehensive Approach to Children with Syndromic Psychomotor Delay
Current Pediatric Reviews Nitric Oxide Related Therapeutic Phenomenon: A Challenging Task
Current Pharmaceutical Design Biological Interfacial Engineering for Metastatic Cancer Diagnosis and Intervention
Current Medicinal Chemistry The Bioenergetics of Isolated Mitochondria from Different Animal Models for Diabetes
Current Diabetes Reviews The Interactions of Anti-Cancer Drugs Approved in the Last Decade in the United States with Membrane Transporters
Anti-Cancer Agents in Medicinal Chemistry Progress in Research of K<sub>V</sub>1.1 and K<sub>V</sub>1.3 Channels as Therapeutic Targets
Current Topics in Medicinal Chemistry Acetylcholinesterase Inhibitors and Drugs Acting on Muscarinic Receptors- Potential Crosstalk of Cholinergic Mechanisms During Pharmacological Treatment
Current Neuropharmacology Late Life Depression: A Diagnostic and Pharmacological Review
Current Psychopharmacology Cardiovascular Pharmacogenetics of Antihypertensive and Lipid- Lowering Therapies
Current Molecular Medicine Effect of Long Chain n-3 PUFA on Endothelial Activation, Endothelial Function and Atheromatous Plaque Stability
Current Nutrition & Food Science Technologies for Translational Imaging Using Generators in Oncology
Recent Patents on Anti-Cancer Drug Discovery The Role of microRNA in Ischemic and Hemorrhagic Stroke
Current Drug Delivery