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Combination of Naltrexone and Baclofen for Alcohol Dependence:A Pilot Study.

Primary Purpose

Alcohol Dependence

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Naltrexone, Baclofen, Placebo and Behavior Therapy
Sponsored by
University of North Carolina, Chapel Hill
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Alcohol Dependence focused on measuring Alcohol, Alcohol Abuse, Alcohol Drinking

Eligibility Criteria

25 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Forty men and women between the ages of 25 to 60 years meeting DSM-IV criteria for current alcohol dependence.
  2. Subjects must either have been admitted to UNC Hospitals for a medical detoxification from alcohol and be receiving benzodiazepines for detoxification or recruited from the general population.
  3. Must have had at least 2 heavy drinking days (≥5 drinks/day for men or ≥4 drinks/day for women) per week, on average and an average overall consumption of 21 drinks/week or more for men and 14 drinks/week or more for women during the 4 weeks prior to admission or screening and no more than three months of abstinence in the previous year.
  4. Able to understand and sign written informed consent.
  5. Willingness to engage in treatment and motivation to achieve abstinence or to greatly reduce alcohol consumption.
  6. Must have a stable residence and be able to identify an individual who could locate subject if needed.
  7. Must have the logistical ability to come to study visits.(This study is being conducted in Chapel Hill, NC. Therefore participants must be able to attend each clinic visit for 12 weeks.)

Exclusion Criteria:

  1. Clinically significant medical disease that might interfere with the evaluation of the study medication or present a safety concern (e.g., cirrhosis, kidney impairment, unstable hypertension, hypotension, diabetes mellitus, seizure disorder).
  2. Patients taking glucocorticoids or immunosuppressants.
  3. Clinically significant psychiatric illness including any psychotic disorder, bipolar disorder, severe depression, persistent suicidal ideation or suicide attempt, or substance use dependence other than alcohol or nicotine.
  4. Any prior history of, or currently presenting with, withdrawal seizure or delirium tremens.
  5. AST, or ALT > 3 times Upper Limit of Normal (ULN), or bilirubin > ULN, or estimated glomerular filtration rate < 60.
  6. Positive urine toxicology screen with the exception of cannabis or cocaine for inpatients only. Patients recruited from the general population who present with a positive urine toxicology screen other than cannabis will be excluded. Any subject with positive cannabis or cocaine screens will be excluded if they have a history of dependence.
  7. Concurrent use of mood stabilizers, antipsychotics, stimulants, or hypnotics. Use of benzodiazepines is prohibited except during the withdrawal period for inpatients. Antidepressant medication is permitted.
  8. Concurrent use of anticonvulsants, insulin, or oral hypoglycemics.
  9. Concurrent use of opiates or any use of opiates within 7 days prior to Naltrexone use.
  10. Participation in any clinical trial within the last 60 days.
  11. Court-mandated participation in alcohol treatment or pending incarceration.
  12. For inpatients, lack of urine toxicology or pregnancy test done on date of hospital admission. Outpatient subjects will have a urine toxicology screen and a pregnancy test done (if female).
  13. If female, pregnant or breastfeeding women and women of child bearing potential who do not practice a medically acceptable form of birth control.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Active Comparator

    Active Comparator

    Active Comparator

    Placebo Comparator

    Arm Label

    1

    2

    3

    4

    Arm Description

    Naltrexone (50 mg once a day) + placebo baclofen + behavioral therapy (n=10)

    Placebo naltrexone + baclofen (10 mg t.i.d) + behavior therapy (n=10)

    Baclofen (10 mg t.i.d) + naltrexone (50 mg once per day) + behavior therapy (n=10)

    Placebo baclofen + placebo naltrexone + behavior therapy

    Outcomes

    Primary Outcome Measures

    This is an exploratory study to gain experience with the combination of baclofen+naltrexone and to gather pilot data on cytokine levels. Initial interest is in recruitment and retention of study participants.

    Secondary Outcome Measures

    Randomized participants complying with study visits and those lost to follow-up will be calculated.Compliance and follow-up are distinct because some participants may provide drinking patterns during follow-up regardless if they continue treatment.

    Full Information

    First Posted
    January 31, 2008
    Last Updated
    May 5, 2011
    Sponsor
    University of North Carolina, Chapel Hill
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00614328
    Brief Title
    Combination of Naltrexone and Baclofen for Alcohol Dependence:A Pilot Study.
    Official Title
    Feasibility and Tolerability of a Combination of Naltrexone and Baclofen for Alcohol Dependence: A Pilot Study.
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2011
    Overall Recruitment Status
    Completed
    Study Start Date
    July 2007 (undefined)
    Primary Completion Date
    January 2010 (Actual)
    Study Completion Date
    January 2010 (Actual)

    3. Sponsor/Collaborators

    Name of the Sponsor
    University of North Carolina, Chapel Hill

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this research study is to learn about the use of a combination of two medications, baclofen and naltrexone, for the treatment of alcohol dependence in men and women ages 25-60 years old. Naltrexone is an FDA approved medication for treatment of alcohol dependence. The most widely accepted idea for naltrexone's effect is that it reduces the alcohol "high", which decreases a desire to consume alcohol. As a result, alcoholic patients treated with naltrexone are less likely to relapse to heavy drinking. Furthermore, naltrexone treated patients drink fewer days and are more likely to maintain abstinence. However, naltrexone does not have any effect on other symptoms that may contribute to relapse such as anxiety, sleep problems and irritability. Baclofen, an FDA approved medication for muscle spasms, may improve some of these symptoms. Therefore, the purpose of the current study is to gather information on whether adding baclofen to naltrexone is feasible and well tolerated.
    Detailed Description
    The purpose of this research study is to learn about the use of a combination of two medications, baclofen and naltrexone, for the treatment of alcohol dependence in men and women ages 25-60 years old. Naltrexone is an FDA approved medication for treatment of alcohol dependence. The most widely accepted idea for naltrexone's effect is that it reduces the alcohol "high", which decreases a desire to consume alcohol. As a result, alcoholic patients treated with naltrexone are less likely to relapse to heavy drinking. Furthermore, naltrexone treated patients drink fewer days and are more likely to maintain abstinence. However, naltrexone does not have any effect on other symptoms that may contribute to relapse such as anxiety, sleep problems and irritability. Baclofen, an FDA approved medication for muscle spasms, may improve some of these symptoms. Baclofen has been studied for alcoholism in Italy in 45 individuals in two studies. In the two Italian studies, baclofen significantly reduced alcohol withdrawal symptoms and craving for alcohol, as well as the use of alcohol. These data have been supported by the results of our own pilot study conducted here at UNC in 12 subjects with alcohol dependence. That study showed that baclofen was generally well tolerated, and some individuals had significant improvements in their drinking. Furthermore, we have recently completed enrolling 80 alcohol dependent patients into a placebo-controlled study of baclofen and are currently analyzing the data. Therefore, the purpose of the current study is to gather information on whether adding baclofen to naltrexone is feasible and well tolerated.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Alcohol Dependence
    Keywords
    Alcohol, Alcohol Abuse, Alcohol Drinking

    7. Study Design

    Primary Purpose
    Basic Science
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    40 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    1
    Arm Type
    Active Comparator
    Arm Description
    Naltrexone (50 mg once a day) + placebo baclofen + behavioral therapy (n=10)
    Arm Title
    2
    Arm Type
    Active Comparator
    Arm Description
    Placebo naltrexone + baclofen (10 mg t.i.d) + behavior therapy (n=10)
    Arm Title
    3
    Arm Type
    Active Comparator
    Arm Description
    Baclofen (10 mg t.i.d) + naltrexone (50 mg once per day) + behavior therapy (n=10)
    Arm Title
    4
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo baclofen + placebo naltrexone + behavior therapy
    Intervention Type
    Drug
    Intervention Name(s)
    Naltrexone, Baclofen, Placebo and Behavior Therapy
    Other Intervention Name(s)
    Naltrexone/ ReVia
    Intervention Description
    Naltrexone 50mg/day for 12 weeks Baclofen 10mg tid = 30mg/day for 12 weeks Behavior Therapy 9 sessions
    Primary Outcome Measure Information:
    Title
    This is an exploratory study to gain experience with the combination of baclofen+naltrexone and to gather pilot data on cytokine levels. Initial interest is in recruitment and retention of study participants.
    Time Frame
    12 Weeks
    Secondary Outcome Measure Information:
    Title
    Randomized participants complying with study visits and those lost to follow-up will be calculated.Compliance and follow-up are distinct because some participants may provide drinking patterns during follow-up regardless if they continue treatment.
    Time Frame
    12 Weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    25 Years
    Maximum Age & Unit of Time
    60 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Forty men and women between the ages of 25 to 60 years meeting DSM-IV criteria for current alcohol dependence. Subjects must either have been admitted to UNC Hospitals for a medical detoxification from alcohol and be receiving benzodiazepines for detoxification or recruited from the general population. Must have had at least 2 heavy drinking days (≥5 drinks/day for men or ≥4 drinks/day for women) per week, on average and an average overall consumption of 21 drinks/week or more for men and 14 drinks/week or more for women during the 4 weeks prior to admission or screening and no more than three months of abstinence in the previous year. Able to understand and sign written informed consent. Willingness to engage in treatment and motivation to achieve abstinence or to greatly reduce alcohol consumption. Must have a stable residence and be able to identify an individual who could locate subject if needed. Must have the logistical ability to come to study visits.(This study is being conducted in Chapel Hill, NC. Therefore participants must be able to attend each clinic visit for 12 weeks.) Exclusion Criteria: Clinically significant medical disease that might interfere with the evaluation of the study medication or present a safety concern (e.g., cirrhosis, kidney impairment, unstable hypertension, hypotension, diabetes mellitus, seizure disorder). Patients taking glucocorticoids or immunosuppressants. Clinically significant psychiatric illness including any psychotic disorder, bipolar disorder, severe depression, persistent suicidal ideation or suicide attempt, or substance use dependence other than alcohol or nicotine. Any prior history of, or currently presenting with, withdrawal seizure or delirium tremens. AST, or ALT > 3 times Upper Limit of Normal (ULN), or bilirubin > ULN, or estimated glomerular filtration rate < 60. Positive urine toxicology screen with the exception of cannabis or cocaine for inpatients only. Patients recruited from the general population who present with a positive urine toxicology screen other than cannabis will be excluded. Any subject with positive cannabis or cocaine screens will be excluded if they have a history of dependence. Concurrent use of mood stabilizers, antipsychotics, stimulants, or hypnotics. Use of benzodiazepines is prohibited except during the withdrawal period for inpatients. Antidepressant medication is permitted. Concurrent use of anticonvulsants, insulin, or oral hypoglycemics. Concurrent use of opiates or any use of opiates within 7 days prior to Naltrexone use. Participation in any clinical trial within the last 60 days. Court-mandated participation in alcohol treatment or pending incarceration. For inpatients, lack of urine toxicology or pregnancy test done on date of hospital admission. Outpatient subjects will have a urine toxicology screen and a pregnancy test done (if female). If female, pregnant or breastfeeding women and women of child bearing potential who do not practice a medically acceptable form of birth control.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    James C Garbutt, M.D.
    Organizational Affiliation
    UNC-Chapel Hill
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Combination of Naltrexone and Baclofen for Alcohol Dependence:A Pilot Study.

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