Osmotic release oral system methylphenidate prevents weight gain during a smoking-cessation attempt in adults with ADHD.
Adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for both cigarette smoking and being overweight or obese. Although smoking cessation tends to result in weight increase, potentially initiating or exacerbating weight problems, adults with ADHD who are treated with osmotic release system methylphenidate (OROS-MPH) tend to lose weight. It is unclear how the use of OROS-MPH during a smoking-cessation attempt might affect the typical weight gain that accompanies cessation. This study focused on changes in weight and hunger during a smoking cessation attempt in 215 adults with ADHD who completed National Drug Abuse Treatment Clinical Trials Network trial CTN-0029 (“A Pilot Study of Osmotic-Release Methylphenidate in Initiating and Maintaining Abstinence in Smokers with ADHD”). Patients in this study were randomized to either OROS-MPH (n=107) or placebo (n=108), with both groups also receiving open-label transdermal nicotine replacement and counseling. Participants who received OROS-MPH lost an average of 1.6% of their body weight during the 11-week study, whereas those who received placebo gained an average of 1.3% of their weight (p<.001). Hunger ratings were lower in the OROS-MPH group than in the placebo group.
Conclusions: The use of OROS-MPH during a smoking-cessation attempt prevents weight gain in adults with ADHD who substantially reduce or quit smoking. Although its effects on hunger and weight did not translate into better overall efficacy for smoking cessation in this study (see Winhusen et al., 2010), when coupled with OROS-MPH’s previously established safety in smokers with ADHD and its efficacy in reducing ADHD symptoms, this clear indication of its effects on postcessation weight gain suggests that future research on the potential benefit of OROS-MPH among particular subgroups of smokers with ADHD — such as those who are deterred from making a quit attempt due to weight concerns or who are prone to relapse as a result of weight gain — may be in order.
Related protocols: CTN-0029