Extended-Release Mixed Amphetamine Salts for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cannabis Use Disorder: A Pilot, Randomized Double-Blind, Placebo-Controlled Trial

J Atten Disord. 2024 Sep;28(11):1467-1481. doi: 10.1177/10870547241264675. Epub 2024 Jul 25.

Abstract

Objective: To determine if treatment of co-occurring adult ADHD and Cannabis Use Disorder (CUD) with extended-release mixed amphetamine salts (MAS-ER) would be effective at improving ADHD symptoms and promoting abstinence.

Method: A 12-week randomized, double-blind, two-arm pilot feasibility trial of adults with comorbid ADHD and CUD (n = 28) comparing MAS-ER (80 mg) to placebo. Main outcomes: ADHD: ≥30% symptom reduction, measured by the Adult ADHD Investigator Symptom Rating Scale (AISRS). CUD: Abstinence during last 2 observed weeks of maintenance phase.

Results: Overall, medication was well-tolerated. There was no significant difference in ADHD symptom reduction (MAS-ER: 83.3%; placebo: 71.4%; p = .65) or cannabis abstinence (MAS-ER: 15.4%; placebo: 0%; p = .27). MAS-ER group showed a significant decrease in weekly cannabis use days over time compared to placebo (p < .0001).

Conclusions: MAS-ER was generally well-tolerated. The small sample size precluded a determination of MAS-ER's superiority reducing ADHD symptoms or promoting abstinence. Notably, MAS-ER significantly reduced weekly days of use over time.

Keywords: adult ADHD; adult ADHD treatment; cannabis use disorder; substance abuse.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Amphetamine / administration & dosage
  • Amphetamine / therapeutic use
  • Amphetamines / administration & dosage
  • Amphetamines / therapeutic use
  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Central Nervous System Stimulants* / administration & dosage
  • Central Nervous System Stimulants* / therapeutic use
  • Comorbidity
  • Delayed-Action Preparations*
  • Double-Blind Method
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Marijuana Abuse* / drug therapy
  • Marijuana Abuse* / epidemiology
  • Middle Aged
  • Pilot Projects
  • Treatment Outcome
  • Young Adult

Substances

  • Delayed-Action Preparations
  • Central Nervous System Stimulants
  • Amphetamines
  • Amphetamine