Sean X Luo1, Lirio S Covey1, Mei-Chen Hu1, Theresa M Winhusen2, Edward V Nunes1. 1. Department of Psychiatry, Division on Substance Use Disorders, Columbia University, New York, New York. 2. Division of Addiction Sciences, University of Cincinnati, Cincinnati, Ohio.
Abstract
BACKGROUND AND OBJECTIVES: In a multisite, randomized study (CTN-0029), a 3-month course of Osmotic-Release Oral System Methylphenidate (OROS-MPH) improved smoking cessation in a group of patients with higher baseline severity in Attention-Deficit/Hyperactivity Disorder (ADHD). This treatment, however, worsened smoking cessation outcome in the group with lower baseline ADHD severity. We want to examine whether this differential treatment effect persisted after OROS-MPH was discontinued. METHODS: We conducted a secondary analysis of the 1-month follow-up data from CTN-0029 after the discontinuation of OROS-MPH (N = 134). Nicotine patch was tapered during this month. We tested whether OROS-MPH had an effect on self-reported 7-day abstinence by week, as well as possible treatment by baseline ADHD severity interactions. RESULTS: Abstinence diminished overall in time after the end of the treatment. In the high baseline severity group, patients who received OROS-MPH had an advantage in 7-day abstinence at week 15 (40% for OROS-MPH vs 20% for placebo, odds ratio = 2.63, P = .028). In the lower severity group (n = 121), no difference was detected (29% for OROS-MPH vs 32% for placebo, P = 1.00) between the two treatment groups. There was also a significant treatment by baseline ADHD severity interaction (P = .03). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: OROS-MPH promotes abstinence beyond the course of treatment for patients with more severe ADHD, while the paradoxical effects in the lower baseline severity group is not persistent after medication discontinuation. Targeting ADHD in smoking cessation as a comorbidity therefore can have broader impact with more precise patient selection. (Am J Addict).
RCT Entities:
BACKGROUND AND OBJECTIVES: In a multisite, randomized study (CTN-0029), a 3-month course of Osmotic-Release Oral System Methylphenidate (OROS-MPH) improved smoking cessation in a group of patients with higher baseline severity in Attention-Deficit/Hyperactivity Disorder (ADHD). This treatment, however, worsened smoking cessation outcome in the group with lower baseline ADHD severity. We want to examine whether this differential treatment effect persisted after OROS-MPH was discontinued. METHODS: We conducted a secondary analysis of the 1-month follow-up data from CTN-0029 after the discontinuation of OROS-MPH (N = 134). Nicotine patch was tapered during this month. We tested whether OROS-MPH had an effect on self-reported 7-day abstinence by week, as well as possible treatment by baseline ADHD severity interactions. RESULTS: Abstinence diminished overall in time after the end of the treatment. In the high baseline severity group, patients who received OROS-MPH had an advantage in 7-day abstinence at week 15 (40% for OROS-MPH vs 20% for placebo, odds ratio = 2.63, P = .028). In the lower severity group (n = 121), no difference was detected (29% for OROS-MPH vs 32% for placebo, P = 1.00) between the two treatment groups. There was also a significant treatment by baseline ADHD severity interaction (P = .03). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: OROS-MPH promotes abstinence beyond the course of treatment for patients with more severe ADHD, while the paradoxical effects in the lower baseline severity group is not persistent after medication discontinuation. Targeting ADHD in smoking cessation as a comorbidity therefore can have broader impact with more precise patient selection. (Am J Addict).
Authors: D E Jorenby; S J Leischow; M A Nides; S I Rennard; J A Johnston; A R Hughes; S S Smith; M L Muramoto; D M Daughton; K Doan; M C Fiore; T B Baker Journal: N Engl J Med Date: 1999-03-04 Impact factor: 91.245
Authors: Edward V Nunes; Martina Pavlicova; Mei-Chen Hu; Aimee N Campbell; Gloria Miele; Denise Hien; Donald F Klein Journal: Am J Drug Alcohol Abuse Date: 2011-09 Impact factor: 3.829
Authors: Arthur N Westover; T Michael Kashner; Theresa M Winhusen; Richard M Golden; Paul A Nakonezny; Bryon Adinoff; Steven S Henley Journal: Am J Drug Alcohol Abuse Date: 2015-06-11 Impact factor: 3.829
Authors: Andrea R Vansickel; William W Stoops; Paul E A Glaser; Megan M Poole; Craig R Rush Journal: Psychopharmacology (Berl) Date: 2011-05-18 Impact factor: 4.530
Authors: Edward V Nunes; Lirio S Covey; Gregory Brigham; Mei-Chen Hu; Frances R Levin; Eugene C Somoza; Theresa M Winhusen Journal: J Clin Psychiatry Date: 2013-10 Impact factor: 4.384