title: Methylphenidate and cocaine: a placebo-controlled drug interaction study.
abstract: Up to thirty percent of cocaine addicted individuals may meet diagnostic criteria for Attention-Deficit/Hyperactivity Disorder (ADHD). Methylphenidate (MPH) is a highly effective and commonly used treatment for ADHD but, like cocaine, is a cardiovascular and central nervous system stimulant with the potential to cause toxicity at high doses. The present study was undertaken to investigate the likelihood of a toxic reaction in individuals who use cocaine while concurrently taking MPH. Seven non-treatment seeking cocaine-dependent individuals completed this placebo-controlled, crossover study with two factors: Medication (placebo, 60 mg MPH, 90 mg MPH) and Infusion (saline, 20 mg cocaine, 40 mg cocaine). Physiological measures included vital signs, adverse events, and electrocardiogram. Subjective response was measured with visual analog scale (VAS) ratings of craving and drug effect. Cocaine pharmacokinetic parameters were calculated for each participant at each drug combination, using a non-compartmental model. MPH was well tolerated, did not have a clinically significant impact on cocaine's physiological effects, and decreased some of the positive subjective effects of cocaine. MPH did not significantly alter the pharmacokinetics of cocaine. The study results suggest that MPH at the doses studied can likely be used safely in an outpatient setting with active cocaine users.
authors.affiliation: Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA. winhusen@mdru.uc.edu
authors.forename: Theresa
authors.initials: T
authors.lastname: Winhusen
authors.forename: Eugene
authors.initials: E
authors.lastname: Somoza
authors.forename: Bonita M
authors.initials: BM
authors.lastname: Singal
authors.forename: Judy
authors.initials: J
authors.lastname: Harrer
authors.forename: Sandhya
authors.initials: S
authors.lastname: Apparaju
authors.forename: Juris
authors.initials: J
authors.lastname: Mezinskis
authors.forename: Pankaj
authors.initials: P
authors.lastname: Desai
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elkashef
authors.forename: C Nora
authors.initials: CN
authors.lastname: Chiang
authors.forename: Paul
authors.initials: P
authors.lastname: Horn
mesh_terms: D000328:Adult; D003042:Cocaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D018592:Cross-Over Studies; D004347:Drug Interactions; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D010919:Placebos
chemical_list: D010919:Placebos; D008774:Methylphenidate; D003042:Cocaine