Effects of Varenicline on Brain Activity During Nicotine Abstinence
Primary Purpose
Nicotine Dependence
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Varenicline
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Nicotine Dependence focused on measuring Varenicline, Imaging, fMRI
Eligibility Criteria
Inclusion Criteria:
- Treatment-seeking smokers between the ages of 18 and 65, that smoke at least 10 cigarettes/day for at least the past 6 months
- Provide a baseline CO (carbon monoxide) reading of >10ppm
- Provide written informed consent and are fluent, English-speaking
- Weight of equal to or less than 300 lbs
Exclusion Criteria:
Smoking Behavior
- Use of chewing tobacco, snuff or cigars
- Current enrollment or plans to enroll in another smoking cessation program in the next 5 months
- Plan to use other nicotine substitutes or smoking cessation treatments in the next 5 months
- Provide a baseline CO (carbon monoxide) reading ≤10 ppm
Alcohol/Drug Exclusion Criteria
- History of substance abuse and/or currently receiving treatment for substance abuse
- Current alcohol consumption that exceeds 25 standard drinks/week
- A breath alcohol concentration reading ≥ 0.01 at the H&P (health & physical) screening or either of the lab sessions
Medication Exclusion Criteria
- Prior use of Chantix
Current use or recent discontinuation (within last 14-days) of the following medications:
- Any form of smoking cessation medication
Any form of anti-psychotic medications that includes:
- antipsychotics,
- atypical antipsychotics,
- mood-stabilizers,
- anti-depressants (tricyclic, SSRI, MAOI),
- anti-panic agents,
- anti-obsessive agents,
- anti-anxiety agents, and
- stimulants (e.g., Provigil, Ritalin)
- herbal medications (St. John's Wort)
- Opioid medication for chronic pain
- Anti-coagulants
- Any heart medications
- Daily medication for asthma
Medical Exclusion Criteria
- Women who are pregnant, planning a pregnancy, or lactating;
- History or current diagnosis of psychosis, current major depression, bipolar disorder, ADHD, schizophrenia, or any Axis 1 disorder as identified by the MINI
- Serious or unstable disease within the past 6 months (heart disease, HIV)
- Diagnosis of cancer in the past 6 months or if successful treatment for cancer has not ended within the past 6 months
- History of epilepsy or a seizure disorder
- History or current diagnosis (last 6-months) of abnormal rhythms and/or tachycardia (>100 beats/minute); history or current diagnosis of COPD (chronic obstructive pulmonary disease), cardiovascular disease (stroke, angina, coronary heart disease), heart attack in the last 6 months, uncontrolled hypertension (SBP>150 or DBP>90)
- History of kidney and/or liver failure (including transplant)
- History of head trauma or prior seizure; family history of a seizure disorder, brain (or central nervous system) tumor
- Use of pacemakers, certain metallic implants, or presence of metal in the eye as contraindicated for MRI (magnetic resonance imaging);
- Low or borderline intellectual functioning - determined by receiving a score <80 on the Shipley verbal IQ Test
- Non-English speaking; determined at phone screen
- History of claustrophobia (contraindicated for MRI) or color blindness (task requires color recognition); self-report at telephone screen
- Being left-handed
- Any fore-limb deformity
- Wearing cochlear implant or bi-lateral hearing aids
General Exclusion
- Any medical condition or concomitant medication that could compromise participant safety or treatment, as determined by the Principal Investigator and/or Study Physician.
- Inability to provide informed consent or complete any of the study tasks as determined by the Principal Investigator and/or Study Physician.
- Any physical or visual impairment that may prevent the individual from using a computer keyboard or completing any study tasks.
Sites / Locations
- Tobacco Use Research Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Active Comparator
Arm Label
Placebo
Varenicline
Arm Description
Outcomes
Primary Outcome Measures
Percent Change BOLD Signal
We calculated the percent BOLD signal change while performing the N-back task between the varenicline vs. placebo session. We subtracted BOLD signal observed during the 0-back condition from the BOLD signal observed during the 3-back condition (3back minus 0-back)We controlled for relevant co-variates such as sex, nicotine dependence level and education.
Secondary Outcome Measures
Effect of Varenicline Treatment on Task Performance (N-back Correct Response Time)
We examined the difference in correct reaction time on the N-back task between varenicline and placebo treatment. Models included terms for the main effect of treatment period (varenicline vs. placebo), memory load (0-back, 1-back, 2-back, 3-back) and covariates. We tested for interactions between nicotine dependence severity and treatment.
Full Information
NCT ID
NCT00602927
First Posted
January 15, 2008
Last Updated
May 6, 2011
Sponsor
University of Pennsylvania
Collaborators
Pfizer, National Cancer Institute (NCI)
1. Study Identification
Unique Protocol Identification Number
NCT00602927
Brief Title
Effects of Varenicline on Brain Activity During Nicotine Abstinence
Official Title
Neural Substrates of Varenicline's (Chantix®) Efficacy for Smoking Cessation
Study Type
Interventional
2. Study Status
Record Verification Date
May 2011
Overall Recruitment Status
Completed
Study Start Date
November 2007 (undefined)
Primary Completion Date
August 2008 (Actual)
Study Completion Date
August 2008 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
University of Pennsylvania
Collaborators
Pfizer, National Cancer Institute (NCI)
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This project aims to define mechanisms through which varenicline might be an effective smoking cessation medication.
Detailed Description
Thirty treatment seeking smokers will be recruited to complete a 40-day within-subject (cross-over), double-blind study that will assess effects of varenicline on brain activation while performing certain tasks. Prior to beginning the study, participants will complete an health and physical screening to determine final eligibility. Following a medication run-up and a 3.5 day abstinence period, participants will complete study period 1 (an fMRI scan while performing attention, working memory and emotion tasks). After a 14 to 21-day washout period the study procedures will be repeated with placebo (order of study medication counterbalanced). After completion of both study periods, all participants will be offered a 13-week quit smoking program with varenicline.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nicotine Dependence
Keywords
Varenicline, Imaging, fMRI
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
38 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Title
Varenicline
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Varenicline
Other Intervention Name(s)
Chantix
Intervention Description
Day 1 - Day 3 0.5mg once daily Day 4 - Day 7 0.5mg twice daily Day 8 - Day 13 1.0mg twice daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Participants will take placebo pills for 13 days using the same regimen as the varenicline study period.
Primary Outcome Measure Information:
Title
Percent Change BOLD Signal
Description
We calculated the percent BOLD signal change while performing the N-back task between the varenicline vs. placebo session. We subtracted BOLD signal observed during the 0-back condition from the BOLD signal observed during the 3-back condition (3back minus 0-back)We controlled for relevant co-variates such as sex, nicotine dependence level and education.
Time Frame
Day 13
Secondary Outcome Measure Information:
Title
Effect of Varenicline Treatment on Task Performance (N-back Correct Response Time)
Description
We examined the difference in correct reaction time on the N-back task between varenicline and placebo treatment. Models included terms for the main effect of treatment period (varenicline vs. placebo), memory load (0-back, 1-back, 2-back, 3-back) and covariates. We tested for interactions between nicotine dependence severity and treatment.
Time Frame
Day 13
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Treatment-seeking smokers between the ages of 18 and 65, that smoke at least 10 cigarettes/day for at least the past 6 months
Provide a baseline CO (carbon monoxide) reading of >10ppm
Provide written informed consent and are fluent, English-speaking
Weight of equal to or less than 300 lbs
Exclusion Criteria:
Smoking Behavior
Use of chewing tobacco, snuff or cigars
Current enrollment or plans to enroll in another smoking cessation program in the next 5 months
Plan to use other nicotine substitutes or smoking cessation treatments in the next 5 months
Provide a baseline CO (carbon monoxide) reading ≤10 ppm
Alcohol/Drug Exclusion Criteria
History of substance abuse and/or currently receiving treatment for substance abuse
Current alcohol consumption that exceeds 25 standard drinks/week
A breath alcohol concentration reading ≥ 0.01 at the H&P (health & physical) screening or either of the lab sessions
Medication Exclusion Criteria
Prior use of Chantix
Current use or recent discontinuation (within last 14-days) of the following medications:
Any form of smoking cessation medication
Any form of anti-psychotic medications that includes:
antipsychotics,
atypical antipsychotics,
mood-stabilizers,
anti-depressants (tricyclic, SSRI, MAOI),
anti-panic agents,
anti-obsessive agents,
anti-anxiety agents, and
stimulants (e.g., Provigil, Ritalin)
herbal medications (St. John's Wort)
Opioid medication for chronic pain
Anti-coagulants
Any heart medications
Daily medication for asthma
Medical Exclusion Criteria
Women who are pregnant, planning a pregnancy, or lactating;
History or current diagnosis of psychosis, current major depression, bipolar disorder, ADHD, schizophrenia, or any Axis 1 disorder as identified by the MINI
Serious or unstable disease within the past 6 months (heart disease, HIV)
Diagnosis of cancer in the past 6 months or if successful treatment for cancer has not ended within the past 6 months
History of epilepsy or a seizure disorder
History or current diagnosis (last 6-months) of abnormal rhythms and/or tachycardia (>100 beats/minute); history or current diagnosis of COPD (chronic obstructive pulmonary disease), cardiovascular disease (stroke, angina, coronary heart disease), heart attack in the last 6 months, uncontrolled hypertension (SBP>150 or DBP>90)
History of kidney and/or liver failure (including transplant)
History of head trauma or prior seizure; family history of a seizure disorder, brain (or central nervous system) tumor
Use of pacemakers, certain metallic implants, or presence of metal in the eye as contraindicated for MRI (magnetic resonance imaging);
Low or borderline intellectual functioning - determined by receiving a score <80 on the Shipley verbal IQ Test
Non-English speaking; determined at phone screen
History of claustrophobia (contraindicated for MRI) or color blindness (task requires color recognition); self-report at telephone screen
Being left-handed
Any fore-limb deformity
Wearing cochlear implant or bi-lateral hearing aids
General Exclusion
Any medical condition or concomitant medication that could compromise participant safety or treatment, as determined by the Principal Investigator and/or Study Physician.
Inability to provide informed consent or complete any of the study tasks as determined by the Principal Investigator and/or Study Physician.
Any physical or visual impairment that may prevent the individual from using a computer keyboard or completing any study tasks.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Caryn Lerman, PhD
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tobacco Use Research Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
20207347
Citation
Loughead J, Ray R, Wileyto EP, Ruparel K, Sanborn P, Siegel S, Gur RC, Lerman C. Effects of the alpha4beta2 partial agonist varenicline on brain activity and working memory in abstinent smokers. Biol Psychiatry. 2010 Apr 15;67(8):715-21. doi: 10.1016/j.biopsych.2010.01.016. Epub 2010 Mar 6.
Results Reference
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Effects of Varenicline on Brain Activity During Nicotine Abstinence
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