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Study of Bupropion Versus Bupropion + Naltrexone for Smoking Cessation

Primary Purpose

Tobacco Use Disorder

Status
Unknown status
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Bupropion
Bupropion + Naltrexone
Sponsored by
University of Minnesota
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tobacco Use Disorder focused on measuring nicotine, smoking, addiction

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • 18 years and older.
  • Smoked at least 10 cigarettes/day for at least 1 year.
  • English speaking.
  • Females who are of childbearing potential must practice effective contraception and meet the following criteria:
  • Are instructed to avoid pregnancy through 30 days after the last dose of study medication.
  • Have a negative urine pregnancy test at baseline.
  • Agree to use of the birth control methods listed: an oral contraceptive agent, an intrauterine device (IUD), an implantable contraceptive (e.g., Norplant), or an injectable contraceptive (e.g., Depo-Provera) for at least one month prior to entering the study and will continue its use through at least 30 days after the last dose of the study medication. A barrier method of contraception (e.g., condom or diaphragm with spermicide) while participating in the study and 30 days after the last dose of study medication.
  • Willingness to reduce alcohol consumption during study to 2 or fewer standard drinks/day (3 oz. of alcohol or two beers (12 oz.), or two 5 oz. glasses of wine).
  • Willingness to not use illicit drugs during study period including marijuana.

Exclusion Criteria:

  • Concurrent use of tobacco products (other than cigarettes) or nicotine products.
  • Contraindications to use of bupropion (i.e., concurrent use of other forms of bupropion, MAO inhibitors, anti-depressant medication, seizure disorder or any clinical situation that might increase risk for seizures, past head injury, current or prior diagnosis of bulimia or anorexia nervosa; bipolar disorder).
  • Contraindications to use of naltrexone (i.e., past history of opioid abuse or dependence or evidence of opioid use in the past 30 days; significant hepatocellular injury as evidenced by liver enzyme levels over 3 times normal limits).
  • Use of medications whose metabolism or effects may be adversely altered by bupropion or naltrexone. Medications that contraindicate the use of bupropion include theophylline, procarbazine, carbimazole, nialamide, pargyline, toloxatone, iproniazid, and systemic steroids. Medications that contraindicate the use of naltrexone include opioid analgesics and yohimbine.
  • Current use of anti-seizure medications, disulfiram, or any medications that significantly challenge liver functioning.
  • Treatment for drug or alcohol dependence during the last year, or evidence of alcohol abuse so severe that the patient is judged potentially unable to comply with the protocol.
  • Evidence of problem alcohol consumption based on AUDIT.
  • Self-reported use of illicit drugs in the past 90 days (including opioids, but excluding marijuana).
  • Suicidal or homicidal ideation.
  • Current major depression.
  • History of bipolar disorder.
  • Recent (within twelve months) myocardial infarction.
  • Pregnant or lactating or planning pregnancy during treatment period.
  • Having plans to leave the immediate geographical area within 9 months.
  • Unwillingness or inability to given written informed consent.

Sites / Locations

  • Tobacco Use Research Center, University of MinnesotaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

1

2

Arm Description

Bupropion+Placebo

Bupropion+Naltrexone

Outcomes

Primary Outcome Measures

Biochemically-verified point-prevalence abstinence
Likelihood of progression to a relapse (e.g., return to baseline smoking) following a slip at any time in study.
Treatment completion.
Daily cigarette smoking rate.
Frequency and severity of bupropion and naltrexone side effects.

Secondary Outcome Measures

Attentional bias.
Impulsivity.
Nicotine withdrawal, craving and negative/positive affect.

Full Information

First Posted
January 8, 2007
Last Updated
December 2, 2009
Sponsor
University of Minnesota
Collaborators
National Institute on Drug Abuse (NIDA)
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1. Study Identification

Unique Protocol Identification Number
NCT00419731
Brief Title
Study of Bupropion Versus Bupropion + Naltrexone for Smoking Cessation
Official Title
Phase II Randomized, Double-Blind Trial of Bupropion Versus Bupropion + Naltrexone for Smoking Cessation
Study Type
Interventional

2. Study Status

Record Verification Date
December 2009
Overall Recruitment Status
Unknown status
Study Start Date
November 2006 (undefined)
Primary Completion Date
February 2010 (Anticipated)
Study Completion Date
July 2010 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
University of Minnesota
Collaborators
National Institute on Drug Abuse (NIDA)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to compare the effects of bupropion + placebo to bupropion + naltrexone as treatments to help smokers quit.
Detailed Description
The purpose of this study is to compare the effects of bupropion + placebo to bupropion + naltrexone as treatments to help smokers quit. Bupropion is an FDA-approved medication for smoking cessation that is believed to provide relief from craving and withdrawal through promotion of two neurotransmitter chemicals, dopamine and noradrenaline. Naltrexone is an FDA-approved medication for the treatment of opiate and alcohol dependence, that appears to function through blocking certain opiate receptors in the brain. It is expected that bupropion + naltrexone will produce higher smoking quit rates than bupropion + placebo. Bupropion alone is effective in alleviating some nicotine withdrawal complaints and craving for nicotine. However, bupropion does not reduce the rewarding effects of slips to smoking. Naltrexone alone is not generally effective as a smoking cessation medication, but it does help to reduce the rewarding effects of slips to smoking. Thus, it may help to prevent full relapse to smoking. In addition, naltrexone can help to reduce craving for cigarettes. It is hypothesized that the differing complementary actions of the two drugs will help smokers more than bupropion alone. In addition to examining smoking quit rates, the proposed study will also look at psychological processes that change during smoking cessation including, nicotine withdrawal, nicotine craving, mood, impulsivity, and attention

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tobacco Use Disorder
Keywords
nicotine, smoking, addiction

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Active Comparator
Arm Description
Bupropion+Placebo
Arm Title
2
Arm Type
Experimental
Arm Description
Bupropion+Naltrexone
Intervention Type
Drug
Intervention Name(s)
Bupropion
Intervention Description
Sustained-release, 150 mg, q.d., for days 1-3, 150 mg, b.i.d., for balance of 7 weeks. Placebo, 25 mg, q.d., for 7 weeks.
Intervention Type
Drug
Intervention Name(s)
Bupropion + Naltrexone
Intervention Description
Bupropion, Sustained-release, 150 mg, q.d., for days 1-3, 150 mg, b.i.d., for balance of 7 weeks. Naltrexone, 25 mg, q.d., for 7 weeks.
Primary Outcome Measure Information:
Title
Biochemically-verified point-prevalence abstinence
Time Frame
7, 11, 16, and 30 weeks post-quit
Title
Likelihood of progression to a relapse (e.g., return to baseline smoking) following a slip at any time in study.
Time Frame
At any point following the quit date.
Title
Treatment completion.
Time Frame
Weeks 7 and 30.
Title
Daily cigarette smoking rate.
Time Frame
Weekly
Title
Frequency and severity of bupropion and naltrexone side effects.
Time Frame
Weekly during treatment
Secondary Outcome Measure Information:
Title
Attentional bias.
Time Frame
Weeks 1, 3, and 7.
Title
Impulsivity.
Time Frame
Weeks 1, 3, and 7.
Title
Nicotine withdrawal, craving and negative/positive affect.
Time Frame
All visits.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: 18 years and older. Smoked at least 10 cigarettes/day for at least 1 year. English speaking. Females who are of childbearing potential must practice effective contraception and meet the following criteria: Are instructed to avoid pregnancy through 30 days after the last dose of study medication. Have a negative urine pregnancy test at baseline. Agree to use of the birth control methods listed: an oral contraceptive agent, an intrauterine device (IUD), an implantable contraceptive (e.g., Norplant), or an injectable contraceptive (e.g., Depo-Provera) for at least one month prior to entering the study and will continue its use through at least 30 days after the last dose of the study medication. A barrier method of contraception (e.g., condom or diaphragm with spermicide) while participating in the study and 30 days after the last dose of study medication. Willingness to reduce alcohol consumption during study to 2 or fewer standard drinks/day (3 oz. of alcohol or two beers (12 oz.), or two 5 oz. glasses of wine). Willingness to not use illicit drugs during study period including marijuana. Exclusion Criteria: Concurrent use of tobacco products (other than cigarettes) or nicotine products. Contraindications to use of bupropion (i.e., concurrent use of other forms of bupropion, MAO inhibitors, anti-depressant medication, seizure disorder or any clinical situation that might increase risk for seizures, past head injury, current or prior diagnosis of bulimia or anorexia nervosa; bipolar disorder). Contraindications to use of naltrexone (i.e., past history of opioid abuse or dependence or evidence of opioid use in the past 30 days; significant hepatocellular injury as evidenced by liver enzyme levels over 3 times normal limits). Use of medications whose metabolism or effects may be adversely altered by bupropion or naltrexone. Medications that contraindicate the use of bupropion include theophylline, procarbazine, carbimazole, nialamide, pargyline, toloxatone, iproniazid, and systemic steroids. Medications that contraindicate the use of naltrexone include opioid analgesics and yohimbine. Current use of anti-seizure medications, disulfiram, or any medications that significantly challenge liver functioning. Treatment for drug or alcohol dependence during the last year, or evidence of alcohol abuse so severe that the patient is judged potentially unable to comply with the protocol. Evidence of problem alcohol consumption based on AUDIT. Self-reported use of illicit drugs in the past 90 days (including opioids, but excluding marijuana). Suicidal or homicidal ideation. Current major depression. History of bipolar disorder. Recent (within twelve months) myocardial infarction. Pregnant or lactating or planning pregnancy during treatment period. Having plans to leave the immediate geographical area within 9 months. Unwillingness or inability to given written informed consent.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Marc E Mooney, Ph.D.
Phone
612-273-9732
Email
moon0078@umn.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Dorothy K Hatsukami, Ph.D.
Phone
612-626-2121
Email
hatsu001@umn.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marc E Mooney, Ph.D.
Organizational Affiliation
Univerisity of Minnesota
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tobacco Use Research Center, University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55414
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marc E Mooney, Ph.D.
Phone
612-273-9732
Email
moon0078@umn.edu
First Name & Middle Initial & Last Name & Degree
Marc E Mooney, Ph.D.

12. IPD Sharing Statement

Citations:
PubMed Identifier
7665537
Citation
Ascher JA, Cole JO, Colin JN, Feighner JP, Ferris RM, Fibiger HC, Golden RN, Martin P, Potter WZ, Richelson E, et al. Bupropion: a review of its mechanism of antidepressant activity. J Clin Psychiatry. 1995 Sep;56(9):395-401.
Results Reference
background
PubMed Identifier
16831112
Citation
Mooney ME, Sofuoglu M. Bupropion for the treatment of nicotine withdrawal and craving. Expert Rev Neurother. 2006 Jul;6(7):965-81. doi: 10.1586/14737175.6.7.965.
Results Reference
background
PubMed Identifier
12095672
Citation
Lerman C, Roth D, Kaufmann V, Audrain J, Hawk L, Liu A, Niaura R, Epstein L. Mediating mechanisms for the impact of bupropion in smoking cessation treatment. Drug Alcohol Depend. 2002 Jul 1;67(2):219-23. doi: 10.1016/s0376-8716(02)00067-4.
Results Reference
background
PubMed Identifier
10663415
Citation
Shiffman S, Johnston JA, Khayrallah M, Elash CA, Gwaltney CJ, Paty JA, Gnys M, Evoniuk G, DeVeaugh-Geiss J. The effect of bupropion on nicotine craving and withdrawal. Psychopharmacology (Berl). 2000 Jan;148(1):33-40. doi: 10.1007/s002130050022.
Results Reference
background
PubMed Identifier
10102765
Citation
Hutchison KE, Monti PM, Rohsenow DJ, Swift RM, Colby SM, Gnys M, Niaura RS, Sirota AD. Effects of naltrexone with nicotine replacement on smoking cue reactivity: preliminary results. Psychopharmacology (Berl). 1999 Feb;142(2):139-43. doi: 10.1007/s002130050872.
Results Reference
background
PubMed Identifier
10615738
Citation
Wong GY, Wolter TD, Croghan GA, Croghan IT, Offord KP, Hurt RD. A randomized trial of naltrexone for smoking cessation. Addiction. 1999 Aug;94(8):1227-37. doi: 10.1046/j.1360-0443.1999.948122713.x.
Results Reference
background
PubMed Identifier
14750508
Citation
Krishnan-Sarin S, Meandzija B, O'Malley S. Naltrexone and nicotine patch smoking cessation: a preliminary study. Nicotine Tob Res. 2003 Dec;5(6):851-7. doi: 10.1080/14622200310001614601.
Results Reference
background
PubMed Identifier
12851023
Citation
Williams J, Ziedonis DM. Naltrexone-bupropion combination therapy for protracted abstinence dysphoria. Am J Addict. 2003 May-Jun;12(3):270-2. No abstract available.
Results Reference
background
PubMed Identifier
14724039
Citation
Epstein AM, King AC. Naltrexone attenuates acute cigarette smoking behavior. Pharmacol Biochem Behav. 2004 Jan;77(1):29-37. doi: 10.1016/j.pbb.2003.09.017.
Results Reference
background
PubMed Identifier
17008194
Citation
King A, de Wit H, Riley RC, Cao D, Niaura R, Hatsukami D. Efficacy of naltrexone in smoking cessation: a preliminary study and an examination of sex differences. Nicotine Tob Res. 2006 Oct;8(5):671-82. doi: 10.1080/14622200600789767.
Results Reference
background
PubMed Identifier
10899371
Citation
King AC, Meyer PJ. Naltrexone alteration of acute smoking response in nicotine-dependent subjects. Pharmacol Biochem Behav. 2000 Jul;66(3):563-72. doi: 10.1016/s0091-3057(00)00258-6.
Results Reference
background
PubMed Identifier
10367550
Citation
Brauer LH, Behm FM, Westman EC, Patel P, Rose JE. Naltrexone blockade of nicotine effects in cigarette smokers. Psychopharmacology (Berl). 1999 Apr;143(4):339-46. doi: 10.1007/s002130050957.
Results Reference
background
PubMed Identifier
12810146
Citation
Ahmadi J, Ashkani H, Ahmadi M, Ahmadi N. Twenty-four week maintenance treatment of cigarette smoking with nicotine gum, clonidine and naltrexone. J Subst Abuse Treat. 2003 Apr;24(3):251-5. doi: 10.1016/s0740-5472(03)00027-8.
Results Reference
background
PubMed Identifier
8539322
Citation
Sutherland G, Stapleton JA, Russell MA, Feyerabend C. Naltrexone, smoking behaviour and cigarette withdrawal. Psychopharmacology (Berl). 1995 Aug;120(4):418-25. doi: 10.1007/BF02245813.
Results Reference
background
PubMed Identifier
9860109
Citation
Wewers ME, Dhatt R, Tejwani GA. Naltrexone administration affects ad libitum smoking behavior. Psychopharmacology (Berl). 1998 Nov;140(2):185-90. doi: 10.1007/s002130050756.
Results Reference
background
PubMed Identifier
10234561
Citation
Covey LS, Glassman AH, Stetner F. Naltrexone effects on short-term and long-term smoking cessation. J Addict Dis. 1999;18(1):31-40. doi: 10.1300/J069v18n01_04.
Results Reference
background
PubMed Identifier
9491065
Citation
Lerner AG, Oyffe I, Sigal M. Naltrexone-induced reduction of tobacco intake. J Clin Psychiatry. 1998 Jan;59(1):30-1. doi: 10.4088/jcp.v59n0107c. No abstract available.
Results Reference
background
PubMed Identifier
11687036
Citation
David S, Lancaster T, Stead LF. Opioid antagonists for smoking cessation. Cochrane Database Syst Rev. 2001;(3):CD003086. doi: 10.1002/14651858.CD003086.
Results Reference
background
PubMed Identifier
17587504
Citation
Toll BA, Leary V, Wu R, Salovey P, Meandzija B, O'Malley SS. A preliminary investigation of naltrexone augmentation of bupropion to stop smoking with less weight gain. Addict Behav. 2008 Jan;33(1):173-9. doi: 10.1016/j.addbeh.2007.05.012. Epub 2007 Jun 2.
Results Reference
background
PubMed Identifier
19364254
Citation
Plodkowski RA, Nguyen Q, Sundaram U, Nguyen L, Chau DL, St Jeor S. Bupropion and naltrexone: a review of their use individually and in combination for the treatment of obesity. Expert Opin Pharmacother. 2009 Apr;10(6):1069-81. doi: 10.1517/14656560902775750.
Results Reference
background
PubMed Identifier
27213949
Citation
Mooney ME, Schmitz JM, Allen S, Grabowski J, Pentel P, Oliver A, Hatsukami DK. Bupropion and naltrexone for smoking cessation: A double-blind randomized placebo-controlled clinical trial. Clin Pharmacol Ther. 2016 Oct;100(4):344-52. doi: 10.1002/cpt.402. Epub 2016 Jun 20.
Results Reference
derived

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Study of Bupropion Versus Bupropion + Naltrexone for Smoking Cessation

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