Assessing methylphenidate preference in ADHD patients using a choice procedure.

Emily MacDonald Fredericks; Scott H Kollins

doi:10.1007/s00213-004-1838-2

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Assessing methylphenidate preference in ADHD patients using a choice procedure.

Emily MacDonald Fredericks·Scott H Kollins

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Abstract

RATIONALE: Methylphenidate (MPH) is widely used in the treatment of attention deficit hyperactivity disorder (ADHD) and is associated with positive clinical effects across a wide range of domains. Despite the clinical effectiveness of MPH, concern has arisen with respect to its abuse potential. OBJECTIVES: To assess MPH preference in adults diagnosed with ADHD using a choice procedure and to evaluate the relationship among drug preference, therapeutic efficacy, and abuse potential in a clinical sample. METHODS: Participants were ten volunteers (ages 18-22 years) with ADHD who were receiving MPH treatment. Preference was assessed using a double-blind choice procedure with four sampling sessions wherein subjects received either placebo or MPH and eight choice sessions when they chose either capsule or no capsules. RESULTS: Overall, MPH was chosen significantly more often than placebo (chi2=52.5; P<0.001) and participants were equally separated into groups of those who chose MPH reliably (MPH choosers) and those who did not (MPH non-choosers). MPH decreased ADHD symptoms and resulted in lower ratings of stimulant effects among MPH choosers. MPH choosers also reported higher levels of baseline ADHD symptoms. CONCLUSIONS: Despite higher preference of MPH than placebo in this clinical sample, other measures of abuse potential were not elevated, and MPH choosers were more symptomatic than non-choosers. As such, MPH preference in ADHD populations likely reflects therapeutic efficacy rather than abuse potential. Future work should examine MPH choice in diagnosed and non-diagnosed populations to further explore the role of clinical efficacy in the preference of this stimulant drug.

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Adolescent Adult Attention Deficit Disorder with Hyperactivity Central Nervous System Stimulants Choice Behavior Dose-Response Relationship, Drug Double-Blind Method Female Humans Male Methylphenidate Reinforcement, Psychology Substance-Related Disorders Surveys and Questionnaires Clinical Trial Journal Article Randomized Controlled Trial

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Emily MacDonald Fredericks, Scott H Kollins. 2004. Assessing methylphenidate preference in ADHD patients using a choice procedure.. https://doi.org/10.1007/s00213-004-1838-2

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