Bupropion for ADHD in Adolescents with Substance Use Disorders

安非他酮治疗患有药物使用障碍的青少年多动症

基本信息

批准号：
8278586
负责人：
Paula DeGraffenreid Riggs
金额：
$ 58.56万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-08-15 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8278586
关键词：
Abstinence Address Adolescent Adult Alcohol or Other Drugs use Area Attention deficit hyperactivity disorder Bupropion Cannabis Cannabis Abuse Clinical Cognitive Therapy Communities Comorbidity Complex Controlled Study Development Diagnostic and Statistical Manual Disease Dopamine Agonists Drug Use Disorder Drug abuse Drug usage Failure Frustration General Population High Prevalence Impairment Impulsivity Individual Intervention Light Marijuana Dependence Marijuana Smoking Mental Depression Mental Health Mental disorders Methamphetamine Methamphetamine dependence Modality Morbidity - disease rate National Institute of Drug Abuse Nicotine Nicotine Dependence Nicotine Withdrawal Nucleus Accumbens Outpatients Participant Pathological Gambling Pharmaceutical Preparations Pharmacotherapy Placebos Population Process Property Public Health Publishing Randomized Controlled Trials Reporting Research Research Design Safety Schools Severities Student Dropouts Substance Use Disorder Substance abuse problem Substance of Abuse Symptoms System Time Treatment outcome United States National Institutes of Health Ventral Tegmental Area Youth addiction adolescent substance abuse base control trial craving depressive symptoms dysphoria effective therapy expectation mortality neurotoxicity nicotine craving outcome forecast protective effect psychosocial randomized placebo controlled trial research and development response smoking cessation treatment program

项目摘要

DESCRIPTION (provided by applicant): This application is a revised resubmission of R01 DA022284, initially reviewed by NIDA-L in June 2006. The application proposes a randomized, placebo-controlled trial of bupropion + cognitive behavioral therapy (CBT) to evaluate the efficacy of this combined therapy for attention deficit hyperactivity disorder (ADHD) in adolescents in whom these disorders commonly co-occur. ADHD is one of the most common co-occurring psychiatric disorders (30-50%) in adolescents with substance use disorders (SUD) and has been associated with more severe drug abuse, school failure, long-term psychosocial impairment, and poorer substance treatment outcomes. Research has shown that bupropion is a safe and effective treatment for both ADHD and nicotine dependence in individuals without SUD, and newer research provides empirical support for its unique pharmacotherapeutic properties and potential for treating other addictive disorders (e.g., methamphetamine dependence, pathological gambling). No controlled studies have yet evaluated bupropion's safety and efficacy for ADHD and SUD (including nicotine and cannabis) in adolescents. The lack of research on the safety and efficacy of medications in adolescents with SUD and psychiatric comorbidities contributes to a serious lack of integrated treatment for commonly co-occurring mental health and substance problems in community-based adolescent drug treatment programs. This then contributes to poorer treatment outcomes and prognosis for the large number of comorbid youths with substance abuse and mental health problems that significantly impact public health. The specific aims of the proposed study will address this research gap by conducting a 16-week randomized controlled trial of bupropion vs. placebo to evaluate the safety and efficacy of this low abuse potential medication on ADHD, nicotine dependence, and cannabis use disorders (not excluding other SUD) in 130 adolescents (13-19) receiving concurrent outpatient substance treatment (CBT). The study design and analytic approach will enable assessment of the complex inter-relationship between change in ADHD, depression/dysphoria (and other psychiatric symptoms) and change in nicotine, cannabis and other substance use within and between treatment groups. Thus, the application addresses important research gaps in at least two priority areas of the NIDA/NIH research agenda: 1) research on effective treatments for adolescents with addiction and psychiatric comorbidity, and 2) medications development research for nicotine and cannabis use disorders in adolescents.

DESCRIPTION (provided by applicant): This application is a revised resubmission of R01 DA022284, initially reviewed by NIDA-L in June 2006. The application proposes a randomized, placebo-controlled trial of bupropion + cognitive behavioral therapy (CBT) to evaluate the efficacy of this combined therapy for attention deficit hyperactivity disorder (ADHD) in adolescents in whom these disorders commonly共发生。多动症是患有药物使用障碍的青少年（SUD）中最常见的精神疾病（30-50％）之一，并且与更严重的药物滥用，学校衰竭，长期的社会心理障碍和较差的药物治疗相关。研究表明，安非他酮是对没有SUD的个体的ADHD和Nicotine依赖性的安全有效治疗，而较新的研究为其独特的药物治疗性能和治疗其他成瘾性疾病的潜力（例如甲基苯胺依赖性，病理学赌博）提供了经验支持。尚无对照研究评估青少年对ADHD和SUD（包括尼古丁和大麻的ADHD和SUD）的安全性和功效。缺乏对药物的安全性和有效性的研究，在患有SUD和精神病合并症的青少年中，在基于社区的青少年药物治疗计划中通常会严重缺乏综合治疗的精神健康和物质问题。然后，这导致了较差的治疗结果和预后，这对大量的滥用药物和心理健康问题的合并症年轻人对公共卫生的影响很大。 The specific aims of the proposed study will address this research gap by conducting a 16-week randomized controlled trial of bupropion vs. placebo to evaluate the safety and efficacy of this low abuse potential medication on ADHD, nicotine dependence, and cannabis use disorders (not excluding other SUD) in 130 adolescents (13-19) receiving concurrent outpatient substance treatment (CBT).研究设计和分析方法将能够评估ADHD，抑郁/烦躁不安（以及其他精神病症状）的变化与尼古丁，大麻和治疗组之间和其他物质使用之间的复杂相互关系。因此，该申请解决了NIDA/NIH研究议程的至少两个优先领域的重要研究差距：1）对成瘾和精神病合并症青少年有效治疗的研究，以及2）2）针对青少年中尼古丁和大麻的药物开发研究。