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.