Methylphenidate for Comorbid Cocaine Abuse, ADHD

In an inpatient study with 14 non-treatment-seeking volunteers, Columbia University researcher Dr. Stephanie Collins and colleagues reported that a regimen of 40-60 mg/day of sustained-release methylphenidate (SR-MPH) reduced ratings on scales of "feel high," "good drug effect," and other measures of cocaine's reinforcing effects among seven abusers affected by attention deficit hyperactivity disorder (ADHD). The medication increased the cardiovascular effects seen with cocaine alone, but not to dangerous levels. Although preliminary, the findings suggest that a therapeutic approach of using slow-acting stimulants to reduce craving for cocaine—parallel to the use of methadone or buprenorphine in opiate addiction—may be possible for cocaine-addicted patients with ADHD. Although the researchers did not formally assess SR-MPH's effects on participants' ADHD symptoms, they did not note any obvious benefits.

Drug and Alcohol Dependence 82(2):158-167, 2006.