I’ve recently completed a study that I presented at the Society For Neuroscience (SFN) meeting in DC. The study was actually aimed at looking at the usefulness of two medications in interfering with the rewarding qualities of methamphetamine. The thinking was the if we could figure out a way to interfere with crystal meth being perceived as rewarding by the brain, we may be able to help addicts from continued use after a relapse.
Two prescription stones but only one hits crystal meth
The two medications are atomoxetine and bupropion, though you may know them as Strattera and Wellbutrin or Zyban. Their mechanisms of action are similar, but distinct enough that we wanted to test them both. The results of the study, in one sentence, were that atomoxetine (or Strattera), but not bupropion (or Zyban) succeeded in eliminating animals’ preference for meth if given along with it. The implication is that in the future, these, or other, similar, medications, may be given to newly recovering addicts. The hope would be that by taking the drug, they may be somewhat protected in the case of a relapse. If they don’t enjoy the drug during the relapse, they may have a better chance of staying in treatment.
More to these medications than meets the eye
I learned some other interesting things while preparing, and then carrying out, the study. While Zyban could, by itself, be liked by the animals, Strattera did not seem to produce any sort of preference. Given the common use of these drugs in the treatment of ADHD, the difference may be very important. As you may recall, I’ve talked before about the connection between impulse control problems and being predisposed to developing addiction. Given this relationship, it would seem that we’d want to be especially careful about using drugs that can cause abuse with this population. Many of the stimulants used to treat ADD and ADHD can indeed lead to abuse, as their effects are very similar to speed, or crystal meth (Adderall and Ritalin come to mind). Zyban’s abuse liability is definitely lower, given the greatly reduced preference animals develop for it. Still, it seems that Strattera’s abuse potential is almost zero. In trial after trial, animals given atomoxetine fail to show a preference for the drug.
To my mind, this means that as long as it’s successful in treating the attention problems, atomoxetine is the better candidate. All in all, I’d think the first choice should be the one that helps the symptoms of ADHD while having a reduced likelihood of dependence. Obviously, if the drug is not able to treat the problem, other options should be selected, but it seems to me that given the known relationship between attention deficit problems and addiction, the question of abuse liability should play a significant role in the selection of medication.
Once again, this doesn’t mean that all users of Adderall, Ritalin, or the other stimulant ADHD medications will develop an addiction to their prescription. In fact, we know that rates of addiction to prescriptions are generally relatively low. Nevertheless, I’d consider ADHD patients a vulnerable population when it comes to substance abuse so I say better safe than sorry.
8 responses to “ADD and ADHD medications: Lessons from a crystal meth experiment”
[…] current entry of the blog is entitled “ADD and ADHD medications: Lessons from a crystal meth experiment.” He explains that in a study he has recently completed he found that there are some forms of […]
Hi I was diagnosed with severe add as a child and was medicated at the time. I dont remember when my parents took me off my meds but it was somtime in my preteens. I strugled all through school with concentration and the ability to retain information. Despite my difficultys i maintained a 2.5-3.0 gradepoint average. I letterd in wrestling excelled in art and gym, and would have laughed and thought you were crazy if you came up to me and told me that i would be a full blown meth addict with in a year of graduation. I was again diognosed with add at a court orderd evaluation at the age of 22, but went unmedicated. I am 36 now Ive been to rehab twice have jumped from job to job with in the construction industry, have been in and out of jail through out my 20s and did an 18 month prison sentence for possesion. I completed parole and for the 1st time scince i was 22 i have no legal issues pending as of 2 years agoe. I have a family that include my fiance my son and her son. They are my whole world. Im in the process of oppening a biusness. Our kids are very well taken care of. They both play football, One plays basketball the other wrestles, One plays hocky the other plays baseball. We attend practices, games help out with team stuff. Go to parent teacher confronces, And do all the things a normal family does. Drugs are never talked about or refrenced in front of the kids except the dangers of them. If the kids joke about them or refernce them as somthing cool, I come down hard on them,and make them write sentenses. Like I play sports i dont do drugs. Any way despite all this there is one tiny hiccup in my family life. My ADD is still untreated and i still struggle with a meth addiction. My whole point is that this article is very promising to me. As far as treating my ADD and my addiction with a medication that my be able to help with both. God knows although from the outside looking in you may not see it i can use it. Thanks for listening any advice is welcome.
This is to JJ in the above post. I was addicted to meth and methadone for the last 12yrs. I finally got out of the addiction game 13 months ago for both. The thing is, I was diagnosed as ADD by my doctor right after rehab. I was put on a high dose (130mg) of Adderall and it has helped me to stay focused but also to stay away from meth. I was serious about recovery this time and felt that 130mg was too much. I have slowly tapered myself down to 45mg of Adderall and doing better now. There is hope, but it takes a while to gain some semblance of feeling. I am still working on it but after 13 months it is getting better each day. Don’t lose hope out there.
Hi. Can you provide a link to the SfN abstract of this study? I am unaware of any head-to-head trial of atomoxetine and bupropion for ADHD and am especially interested to know whether you assessed their comparability with respect to attention and behavior as part of your research design. It may be that bupropion is superior in treating ADHD, and , if so, perhaps for the very reason that it mimics stimulant drug mechanisms to a greater degree than atomoxetine does, as your study seems to confirm.
Also, I’m planning to be in San Diego for the 2011 SfN meeting and would like to drop by your poster if you will be presenting a follow-up on this research.
The experiment was actually a Conditioned Place Preference (CPP) Study to assess the utility of either of those medications in reducing the effect of methamphetamine. It didn’t specifically have to do with ADHD, but since both of the medications are commonly used to treat ADHD, I thought the connnection was relevant. I’ll be at SFN too, though I’ll be presenting a more recent study. I am writing this paper (it was presented last year at SFN) for publication though – we found a significant reduction in CPP magnitude when meth was given in conjuction with Atomoxetine, but not bupropion, btw in case you’re interested.
hello,i have to ask even though the preliminary outlook is good,if something such as the user not enjoying the re-use of meth would even be a deterrent,I have over 20 years experience and know that by the time the meth is to the point of literal destruction,the enjoyment has long been over,just a question,I look forward to hearing from you.
I’m happy that some people are courageous enough to point out the risks that come with ADHD medication. Today it seems like Ritalin and other prescription drugs are everywhere. What many people don’t know is that there can be side-effects and that there long-term effectiveness has never been proven.
Hi Alison and thank you for commenting. For the record, I am FOR medicating kids that are actually suffering from ADHD, I just think we need to be thoughtful regarding the specific medications we give out. 10 years ago there were no good non-stimulant ADHD medications but now we have one and more are being developed as we speak. ADHD is a condition that makes kids feel less than and often hurts their chances of doing well and showing it. I know, I have ADHD and was never appropriately diagnosed as a kid. Instead, I was always singled out as the disruptive kid who couldn’t be respectful and I carry that with me (the stereotype) until today.
Knowing that you have ADHD can begin a real conversation about the most sensitive issues and sometimes, medication is the right answer. BTW, long-term effect in terms of school success and those sorts of outcomes have indeed been documented.