Assessing methylphenidate preference in ADHD patients using a choice procedure.

Journal Article (Clinical Trial;Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Fredericks, EM; Kollins, SH

Published Date

  • October 2004

Published In

Volume / Issue

  • 175 / 4

Start / End Page

  • 391 - 398

PubMed ID

  • 15258716

International Standard Serial Number (ISSN)

  • 0033-3158

Digital Object Identifier (DOI)

  • 10.1007/s00213-004-1838-2


  • eng

Conference Location

  • Germany