Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review.
Heval ÖzgenRenske SpijkermanMoritz NoackMartin HoltmannArnt F A SchellekensSøren DalsgaardWim van den BrinkVincent HendriksPublished in: Journal of clinical medicine (2021)
Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for the development of substance abuse and substance use disorders (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment, and is associated with poor treatment outcomes. In this study, we provide a systematic review of controlled studies on the effectiveness of pharmacological, psychosocial, and complementary treatments of ADHD in adolescents with and without comorbid SUD. In addition, we review the longitudinal association between pharmacotherapy for childhood ADHD and the development of SUD in adolescence and early adulthood. We conducted a systematic review of the research literature published since 2000 using Medline, PsycINFO, and the Cochrane Database of Systematic Reviews databases to select randomized clinical trials, observational studies, and meta-analyses. The quality of the evidence from each study was rated using the SIGN grading system. Based on the limited evidence available, strong clinical recommendations are not justified, but provisionally, we conclude that stimulant treatment in children with ADHD may prevent the development of SUD in adolescence or young adulthood, that high-dose stimulant treatment could be an effective treatment for adolescents with ADHD and SUD comorbidity, that cognitive behavior therapy might have a small beneficial effect in these patients, and that alternative treatments are probably not effective. More studies are needed to draw definitive conclusions that will allow for strong clinical recommendations.
Keyphrases
- attention deficit hyperactivity disorder
- autism spectrum disorder
- working memory
- young adults
- systematic review
- depressive symptoms
- randomized controlled trial
- physical activity
- end stage renal disease
- meta analyses
- mesenchymal stem cells
- mental health
- clinical trial
- combination therapy
- chronic kidney disease
- radiation therapy
- bone marrow
- newly diagnosed
- deep learning
- locally advanced