Sustained-release methylphenidate for cognitive impairment in HIV-1-infected drug abusers: a pilot study

Other investigators have reported clinical improvement from psychostimulant drugs in patients with HIV-1-related cognitive impairment. However, no previous research has substantiated this claim by using a controlled study design. We examined the efficacy of sustained-release methylphenidate (MSR) in a sample of substance abusers with HIV-1-related cognitive impairment. Eight HIV-1-infected methadone patients with impaired neuropsychological test performance participated in an inpatient double-blind placebo-controlled crossover trial of MSR 20-40 mg/day. On a composite neuropsychological measure, patients improved significantly from baseline during MSR but not placebo treatment. Nevertheless, MSR performance did not differ significantly from placebo performance. Patients appeared to improve as a function of time, regardless of sequence, with somewhat more improvement during MSR than placebo treatment.