Director of Substance Abuse Services, Pediatric Psychopharmacology Research Unit
Summary of Research
I have focused my work in three main areas: the overlap of ADHD and substance abuse, the overlap of juvenile bipolar disorder and substance abuse (SA), and the pharmacotherapy of ADHD in children, adolescents, and adults. I have a longstanding interest in understanding the onset of SA as it relates to psychopathology. I was able to demonstrate that ADHD was associated with elevated risk for SA, that the risk was not only linked with psychopathology, but associated with ADHD itself, and that ADHD predicted a more severe course of SA. Subsequently, the role of stimulant treatment of ADHD as protective against the development of SA was elucidated both in our department’s work and replicated by others – work that has had a profound impact on the use of stimulants in younger children with ADHD, implications for other juvenile-onset disorders; as well as in leading other groups to study the association and neurobiological underpinning of risk reduction. I was also able to show that BPD was unequivocally a risk for SA, and that the onset of the BPD in adolescence was particularly noxious for the development of SA. I also showed that the risk for SA was independent of other co-occurring disorders, and was as high in BPD as reported for conduct disorder (juvenile delinquency).
I have conducted a number of clinical trials and extensive reviews on existing medications in ADHD. In part, related to my interests in cigarette smoking and SA, I have also been active in evaluating the role of nicotinic agonists as 1) potential treatment of ADHD, and 2) executive function deficits both within and outside of ADHD. Similarly, I have been involved in the evaluation of a number of existing agents and of novel compounds for the treatment of ADHD. I have also studied (efficacy, pharmacokinetics, safety) the use of monotherapy for ADHD with co-occurring medical and psychiatric morbidity as well as the use of combined pharmacotherapy for comorbid and refractory ADHD. I have collaborated with MGH laboratories to study the pharmacokinetics of ADHD agents and their effects on the cardiac conduction system – data which is commonly cited and used by agencies such as the FDA and American Heart Association for safety assessments.
Ongoing Projects
DA14419 (NIDA) Long-Term Drug Abuse Outcome in ADHD Girls
CTN0029 A Pilot Study of Osmotic-Release Methylphenidate (OROS-MPH) in Initiating and Maintaining Abstinence in Smokers with Attention Deficit Hyperactivity Disorder (ADHD)
Efficacy of Atomoxetine for Attention Deficit Hyperactivity Disorder (ADHD) in Adolescents with Substance Use Disorders (SUD)
Combined OROS Methylphenidate and Atomoxetine Treatment in Children with ADHD
Contact Information
Phone: 617-725-1731
Fax: 617-724-1540
E-mail: twilens@partners.org
