Bupropion for ADHD in Adolescents With Substance Use Disorder
Status:
Completed
Trial end date:
2013-05-01
Target enrollment:
Participant gender:
Summary
Attention deficit hyperactivity disorder (ADHD) is one of the most common co-occurring
psychiatric disorders (30-50%) in adolescents with substance use disorders (SUD). Yet, little
is known about the safety and efficacy of medications for ADHD in adolescents with SUD, since
such youths have been excluded from most medication trials. Clinicians are therefore
understandably reluctant to treat ADHD in substance abusing adolescents, often first
referring such youths to substance treatment. Untreated ADHD is associated with poorer
substance treatment outcomes. We address this research gap by proposing a randomized
controlled trial of bupropion vs placebo in 130 adolescents (13-19 years) with Diagnostic and
Statistical Manual (DSM IV) ADHD, nicotine dependence and cannabis use disorder (not
excluding other SUD). Participants in both bupropion and placebo treatment groups will
receive weekly individual manualized-standardized cognitive behavioral therapy (CBT)
targeting SUD (at no cost to them) throughout the 16 weeks of the medication trial. Bupropion
also is effective in treating nicotine dependence in adults; the majority of adolescents with
marijuana and other drug abuse also smoke tobacco. More recent research in adults indicates
that bupropion may reduce craving and use of other substances of abuse (e.g. methamphetamine,
cocaine). It's possible impact on cannabis use disorder (the addiction for which most teens
are referred to treatment) has not yet been evaluated. However since all drugs of abuse have
a final common pathway leading to addiction via action in the so called brain reward system
(ventral tegmental area (VTA), accumbens) -an important secondary aim is to evaluate
bupropion's potential impact on craving and use of marijuana (MJ) in addition to its known
similar action on nicotine.