Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.

Substantial evidence has confirmed the high comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and a substance use disorder (SUD). This review synthesizes the pharmacological and psychosocial interventions conducted in ADHD and SUDs, and provides clinical recommendations using the G...

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Autores: Cunill R, Castells X, González-Pinto A, Arrojo M, Bernardo M, Sáiz PA, Florez G, Torrens M, Tirado-Muñoz J, Fonseca F, Arranz B, Garriga M, Goikolea JM, Zorrilla I, Becoña E, López A, San L
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p19797
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19797
https://adicciones.es/index.php/adicciones/article/view/1569
Access Level:acceso abierto
Palabra clave:Attention-Deficit/Hyperactivity Disorder
ADHD
substance use
cannabis
cocaine
alcohol
nicotine
psychostimulants
methylphenidate
lisdexamfetamine dimesylate
atomoxetine
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spelling Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.Cunill RCastells XGonzález-Pinto AArrojo MBernardo MSáiz PAFlorez GTorrens MTirado-Muñoz JFonseca FArranz BGarriga MGoikolea JMZorrilla IBecoña ELópez ASan LAttention-Deficit/Hyperactivity DisorderADHDsubstance usecannabiscocainealcoholnicotinepsychostimulantsmethylphenidatelisdexamfetamine dimesylateatomoxetineSubstantial evidence has confirmed the high comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and a substance use disorder (SUD). This review synthesizes the pharmacological and psychosocial interventions conducted in ADHD and SUDs, and provides clinical recommendations using the GRADE approach. Our results suggest: 1) In patients with ADHD and alcohol use, atomoxetine is recommended to reduce ADHD symptoms (weak recommendation) and alcohol craving (weak recommendation). 2) In patients with ADHD and cannabis use disorder, atomoxetine is recommended to improve ADHD symptoms (weak recommendation), not to reduce cannabis use (weak recommendation). 3) In patients with ADHD and cocaine use disorder, methylphenidate is not recommended to improve ADHD symptoms or to reduce cocaine use (weak recommendation). 4) In patients with ADHD and comorbid nicotine use disorder, methylphenidate is recommended to improve ADHD symptoms (weak recommendation). Psychoestimulants, such as methylphenidate or lisdexamfetamine dimesylate, are not recommended to reduce nicotine use (weak recommendation). 5) Regarding patients with ADHD and any SUD, the use of psychostimulants is recommended to improve ADHD symptoms (weak recommendation), not to reduce substance use (weak recommendation) or to improve retention to treatment (strong recommendation). In these patients, the use of atomoxetine is recommended to improve ADHD symptoms (weak recommendation), not to decrease substance use (weak recommendation) or to improve retention to treatment (strong recommendation). Atomoxetine and psychostimulants appear to be safe in patients with any SUD (strong recommendation). Our review suggests the need for more research in this area and for larger, multisite, randomized studies to provide more definite and conclusive evidence.SOCIDROGALCOHOL2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19797https://adicciones.es/index.php/adicciones/article/view/1569AdiccionesISSN: 02144840ISSNe: 26046334reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuEspañolinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p197972026-05-27T12:37:41Z
dc.title.none.fl_str_mv Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.
title Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.
spellingShingle Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.
Cunill R
Attention-Deficit/Hyperactivity Disorder
ADHD
substance use
cannabis
cocaine
alcohol
nicotine
psychostimulants
methylphenidate
lisdexamfetamine dimesylate
atomoxetine
title_short Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.
title_full Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.
title_fullStr Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.
title_full_unstemmed Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.
title_sort Clinical practice guideline on pharmacological and psychological management of adult patients with attention deficit and hyperactivity disorder and comorbid substance use.
dc.creator.none.fl_str_mv Cunill R
Castells X
González-Pinto A
Arrojo M
Bernardo M
Sáiz PA
Florez G
Torrens M
Tirado-Muñoz J
Fonseca F
Arranz B
Garriga M
Goikolea JM
Zorrilla I
Becoña E
López A
San L
author Cunill R
author_facet Cunill R
Castells X
González-Pinto A
Arrojo M
Bernardo M
Sáiz PA
Florez G
Torrens M
Tirado-Muñoz J
Fonseca F
Arranz B
Garriga M
Goikolea JM
Zorrilla I
Becoña E
López A
San L
author_role author
author2 Castells X
González-Pinto A
Arrojo M
Bernardo M
Sáiz PA
Florez G
Torrens M
Tirado-Muñoz J
Fonseca F
Arranz B
Garriga M
Goikolea JM
Zorrilla I
Becoña E
López A
San L
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Attention-Deficit/Hyperactivity Disorder
ADHD
substance use
cannabis
cocaine
alcohol
nicotine
psychostimulants
methylphenidate
lisdexamfetamine dimesylate
atomoxetine
topic Attention-Deficit/Hyperactivity Disorder
ADHD
substance use
cannabis
cocaine
alcohol
nicotine
psychostimulants
methylphenidate
lisdexamfetamine dimesylate
atomoxetine
description Substantial evidence has confirmed the high comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and a substance use disorder (SUD). This review synthesizes the pharmacological and psychosocial interventions conducted in ADHD and SUDs, and provides clinical recommendations using the GRADE approach. Our results suggest: 1) In patients with ADHD and alcohol use, atomoxetine is recommended to reduce ADHD symptoms (weak recommendation) and alcohol craving (weak recommendation). 2) In patients with ADHD and cannabis use disorder, atomoxetine is recommended to improve ADHD symptoms (weak recommendation), not to reduce cannabis use (weak recommendation). 3) In patients with ADHD and cocaine use disorder, methylphenidate is not recommended to improve ADHD symptoms or to reduce cocaine use (weak recommendation). 4) In patients with ADHD and comorbid nicotine use disorder, methylphenidate is recommended to improve ADHD symptoms (weak recommendation). Psychoestimulants, such as methylphenidate or lisdexamfetamine dimesylate, are not recommended to reduce nicotine use (weak recommendation). 5) Regarding patients with ADHD and any SUD, the use of psychostimulants is recommended to improve ADHD symptoms (weak recommendation), not to reduce substance use (weak recommendation) or to improve retention to treatment (strong recommendation). In these patients, the use of atomoxetine is recommended to improve ADHD symptoms (weak recommendation), not to decrease substance use (weak recommendation) or to improve retention to treatment (strong recommendation). Atomoxetine and psychostimulants appear to be safe in patients with any SUD (strong recommendation). Our review suggests the need for more research in this area and for larger, multisite, randomized studies to provide more definite and conclusive evidence.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19797
https://adicciones.es/index.php/adicciones/article/view/1569
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19797
https://adicciones.es/index.php/adicciones/article/view/1569
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SOCIDROGALCOHOL
publisher.none.fl_str_mv SOCIDROGALCOHOL
dc.source.none.fl_str_mv Adicciones
ISSN: 02144840
ISSNe: 26046334
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,81155

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