ADHD is a psychiatric condition characterized by problems with inattention, impulsivity, and hyperactivity. Research suggests that some individuals continue to have ADHD symptoms into adulthood, which puts them at greater risk for developing substance abuse problems. Eleven patients meeting DSM-IV diagnostic criteria for cocaine dependence and adult ADHD were entered into a 12-week single-blind trial of divided daily doses of BPR. All patients received weekly individual standardized relapse prevention therapy. Preliminary findings indicate that BPR, in daily divided doses ranging from 250-400 mg, is well tolerated in cocaine abusers with adult ADHD. BPR may reduce both ADHD symptoms and cocaine use. BPR’s efficacy appears to be comparable to methylphenidate (MPH) in terms of reducing ADHD symptoms and cocaine use and improving treatment retention. BPR has several potential advantages compared to MPH: (1) it has lower abuse potential; (2) it is an excellent antidepressant with low cardiotoxic effects; and (3) it does not require the close supervision monitoring that MPH requires. A disadvantage of BPR is that at high doses it increases the risk of seizures. It remains unclear whether BPR or MPH works best for specific types of ADHD. Future work needs to be done using double blind, placebo-controlled designs to investigate BPR, MPH, or other promising medications for the treatment of cocaine abusers with adult ADHD. 2 figures, 3 tables, 41 references