Methylphenidate treatment of adult male prison inmates with attention-deficit
hyperactivity disorder: randomised double-blind placebo-controlled trial with
open-label extension.
Author(s): Ginsberg Y, Lindefors N.
Affiliation(s): Department of Clinical Neuroscience, Division of Psychiatry and Center of
Neurodevelopmental Disorders, Karolinska Institutet, Stockholm, Sweden.
ylva.ginsberg@ki.se
Publication date & source: 2012, Br J Psychiatry. , 200(1):68-73
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.)
RESULTS: Treatment significantly improved ADHD during the trial (P<0.001; Cohen'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.
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