When used with cognitive-behavioral therapy, extended-release mixed amphetamine salts improved outcomes in patients with co-occuring attention-deficit/hyperactivity disorder and cocaine use disorder, report Dr. Frances R. Levin and coauthors in the division of substance abuse at the New York State Psychiatric Institute.

In a double-blind, placebo-controlled trial of 126 adults with comorbid ADHD and cocaine use disorder, patients who received mixed amphetamine salts were more likely than were those in the placebo group to achieve at least a 30% reduction in ADHD symptom severity (60 mg: 30 of 40 participants; odds ratio, 5.23; P < .001; 80 mg: 25 of 43; OR = 2.27; P  = .07; placebo: 17 of 43).

The odds of a cocaine-negative week were higher in the medication group at both dosage levels (80 mg: OR = 5.46; P < .001; 60 mg: OR = 2.92; P = .02), compared with placebo, the investigators found.

The findings “emphasize the importance of screening adults with [cocaine use disorder] for ADHD,” Dr. Levin and colleagues said in the report. “Moreover, since there remain no clearly effective medications for CUD, and individuals with CUD are a heterogeneous population, an effective treatment among the subgroup with ADHD represents a substantial advance,” the authors said.

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