title: Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance dependence: a 24-week randomized placebo-controlled trial.
abstract: OBJECTIVE
  To test the efficacy and safety of osmotic release oral system (OROS) methylphenidate (MPH) in doses up to 180 mg/day to treat attention deficit hyperactivity disorder (ADHD) and prevent any drug relapse in individuals with a co-diagnosis of ADHD and amphetamine dependence.
  
  
  METHODS
  Randomized placebo-controlled 24-week double-blind trial with parallel groups design.
  
  
  METHODS
  Participants were recruited from medium security prisons in Sweden. The medication started within 2 weeks before release from prison and continued in out-patient care with twice-weekly visits, including once-weekly cognitive behavioural therapy.
  
  
  METHODS
  Fifty-four men with a mean age of 42 years, currently incarcerated, meeting DSM-IV criteria for ADHD and amphetamine dependence.
  
  
  METHODS
  Change in self-reported ADHD symptoms, relapse to any drug use (amphetamine and other drugs) measured by urine toxicology, retention to treatment, craving and time to relapse.
  
  
  RESULTS
  The MPH-treated group reduced their ADHD symptoms during the trial (P = 0.011) and had a significantly higher proportion of drug-negative urines compared with the placebo group (P = 0.047), including more amphetamine-negative urines (P = 0.019) and better retention to treatment (P=0.032).
  
  
  CONCLUSIONS
  Methylphenidate treatment reduces attention deficit hyperactivity disorder symptoms and the risk for relapse to substance use in criminal offenders with attention deficit hyperactivity disorder and substance dependence.
authors.affiliation: Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Maija
authors.initials: M
authors.lastname: Konstenius
authors.forename: Nitya
authors.initials: N
authors.lastname: Jayaram-Lindström
authors.forename: Joar
authors.initials: J
authors.lastname: Guterstam
authors.forename: Olof
authors.initials: O
authors.lastname: Beck
authors.forename: Björn
authors.initials: B
authors.lastname: Philips
authors.forename: Johan
authors.initials: J
authors.lastname: Franck
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000523:psychology / Q000628:therapy*; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D057237:Criminals; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D055502:Secondary Prevention / Q000379:methods*; D013548:Sweden; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate
keywords: ADHD; methylphenidate; pharmacotherapy; substance use