title: Methylphenidate increases cigarette smoking in participants with ADHD.
abstract: BACKGROUND
  Methylphenidate (Ritalin®) is commonly prescribed for behavioral problems associated with attention deficit/hyperactivity disorder (ADHD). The results of previous studies suggest that methylphenidate increases cigarette smoking in participants without psychiatric diagnoses. Whether methylphenidate increases cigarette smoking in participants diagnosed with ADHD is unknown.
  
  
  OBJECTIVE
  In this within-subjects, repeated measures experiment, the acute effects of a range of doses of methylphenidate (10, 20, and 40 mg) and placebo were assessed in nine cigarette smokers who were not attempting to quit and met diagnostic criteria for ADHD but no other Axis I psychiatric disorders other than nicotine dependence.
  
  
  METHODS
  Each dose of methylphenidate was tested once while placebo was tested twice. One hour after ingesting drug, participants were allowed to smoke ad libitum for 4 h. Measures of smoking included total cigarettes smoked, total puffs, and carbon monoxide levels. Snacks and decaffeinated drinks were available ad libitum; caloric intake during the 4-h smoking session was calculated.
  
  
  RESULTS
  Methylphenidate increased the total number of cigarettes smoked, total number of puffs, and carbon monoxide levels. Methylphenidate decreased the number of food items consumed and caloric intake.
  
  
  CONCLUSIONS
  The results of this experiment suggest that acutely administered methylphenidate increases cigarette smoking in participants with ADHD, which is concordant with findings from previous studies that tested healthy young adults. These data indicate that clinicians may need to consider non-stimulant options or counsel their patients before starting methylphenidate when managing ADHD-diagnosed individuals who smoke.
authors: Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY 40536, USA.
authors: Andrea R
authors: AR
authors: Vansickel
authors: William W
authors: WW
authors: Stoops
authors: Paul E A
authors: PE
authors: Glaser
authors: Megan M
authors: MM
authors: Poole
authors: Craig R
authors: CR
authors: Rush
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