Methylphenidate treatment of adult male prison inmates with attention-deficit hyperactivity disorder: randomised double-blind placebo-controlled trial with open-label extension

摘要

Background Attention-deficit hyperactivity disorder (ADHD) is highly prevalent in prison inmates, but pharmacological treatment has not yet been evaluated in this group. Aims To evaluate osmotic-release oral system (OROS) methylphenidate in adult male long-term prison inmates with ADHD. Method Randomised, double-blind, placebo-controlled 5-week trial, followed by 47-week open-label extension in 30 prison inmates with ADHD and comorbid disorders. Primary outcome was level of ADHD symptoms after 5 weeks, evaluated by a masked assessor. Secondary outcomes were self-reported ADHD symptoms, global severity and global functioning throughout the 52-week trial, and post hoc treatment response and numbers needed to treat (NNT) (trial registration: [NCT00482313][1].) Results Treatment significantly improved ADHD during the trial ( P 0.001; Cohena€?s d = 2.17), with reduced symptom severity and improved global functioning. The placebo response, cardiovascular measures and adverse events were non-significant; the NNT was 1.1. Attention-deficit hyperactivity disorder symptoms, global severity and global functioning continued to improve during the open-label extension. Conclusions Osmotic-release oral system methylphenidate is an effective treatment for adult male prison inmates with ADHD. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00482313&atom=%2Fbjprcpsych%2F200%2F1%2F68.atom