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Combination of Dronabinol and Clonidine for Cannabis Dependence in Patients With Schizophrenia (DCCS)

Primary Purpose

Cannabis Dependence, Marijuana Dependence

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Dronabinol
Clonidine
Placebo
Sponsored by
Mclean Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cannabis Dependence focused on measuring Cannabis Dependence, Marijuana Dependence, Cannabis Use Disorders, Cannabis Withdrawal, Dronabinol, Clonidine, Schizophrenia

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age range 18-45 years
  2. DSM-IV diagnosis of cannabis dependence, based on the Structured Clinical Interview for DSM-IV (SCID)
  3. DSM-IV diagnosis of schizophrenia or schizoaffective disorder, based on the Structured Clinical Interview for DSM-IV (SCID)
  4. express a desire to quit cannabis use within the next 30 days
  5. have used cannabis on ≥20 days within the past 30 days (i.e., an average of ≥5 day per week)
  6. identify cannabis as their primary drug of abuse; 6) stable on antipsychotic medication for ≥1 month
  7. for women of childbearing age, a negative pregnancy test at screening with agreement to use adequate contraception to prevent pregnancy and monthly pregnancy tests
  8. consent for us to communicate with their prescribing clinician if one exists
  9. furnish the names of 2 locators, who would assist study staff in locating them during the study period
  10. live close enough to McLean Hospital to attend study visits
  11. plan to stay in the Boston area for the next 3 months
  12. are willing and able to sign informed consent.

Exclusion Criteria:

  1. Current diagnosis of other drug or alcohol dependence (excluding nicotine)
  2. significant cardiac disease as indicated by history or suspected by abnormal ECG or history of cardiac symptoms
  3. Positive and Negative Syndrome Scale (PANSS) subscale for positive symptoms of psychosis item > 3 (moderate) at baseline evaluation
  4. current medical condition that could prevent regular study attendance
  5. liver function tests >3 times the upper limit of normal range
  6. history of seizure disorder or history of head trauma or CNS insult that could predispose the subject to seizures
  7. taking clozapine
  8. current suicidal risk
  9. bradycardia less than or equal to 50 bpm, supine blood pressure of less than or equal to 100/65, a seated blood pressure of less than or equal to 90/60, or orthostatic change of >20 systolic or >10 diastolic on standing, at screening or any pre-dose assessment, or symptoms attributable to low BP (i.e. lightheadedness or dizziness on standing)
  10. mental retardation or organic mental disorder
  11. currently in a residential treatment setting in which substance use is monitored and restricted, since the restricted access to drugs could represent an important confounding variable
  12. pregnant, nursing, or, if a woman of childbearing potential, not using a form of birth control judged by the investigator to be effective
  13. concomitant treatment with opioid analgesics, sedative hypnotics, or other known CNS depressants
  14. known hypersensitivity to cannabinoids or sesame oil or clonidine
  15. disease of the gastrointestinal system, liver, or kidneys that may impede metabolism or excretion of dronabinol
  16. inability to read or write in English that would hinder their ability to follow study procedures
  17. history of seizures or a family history of seizures.

Sites / Locations

  • McLean Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Dronabinol + Clonidine

Placebo

Arm Description

Dronabinol titrated to 5 mg three times daily, Clonidine 0.1 mg twice daily

Placebo

Outcomes

Primary Outcome Measures

Change From Baseline in Cannabis Use at 10 Weeks
Subject self-report hits of marijuana per day at week 10

Secondary Outcome Measures

Change in Craving Symptoms From Baseline at 10 Weeks
Scores on the Marijuana Craving Questionnaire (MCQ) (Heishman et al. 2009) - The 4 Factor Total Score. Maximum Score = 84 Minimum Score = 12 The higher the score, the more severe marijuana craving symptoms endorsed by the subject.
Change From Baseline in Cannabis Use at 14 Weeks
Self-report cannabis use at 14 weeks after initiating the study.
Change in Craving Symptoms From Baseline at 14 Weeks
Scores on the Marijuana Craving Questionnaire (Heishman et al. 2009) - The 4 Factor Total Score Maximum Score = 84 Minimum Score = 12 The higher the score, the more severe marijuana craving symptoms endorsed by the subject.

Full Information

First Posted
May 11, 2012
Last Updated
July 31, 2018
Sponsor
Mclean Hospital
Collaborators
Brain & Behavior Research Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT01598896
Brief Title
Combination of Dronabinol and Clonidine for Cannabis Dependence in Patients With Schizophrenia
Acronym
DCCS
Official Title
Combination of Dronabinol and Clonidine for Cannabis Dependence in Patients With Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Terminated
Why Stopped
low enrollment due to limited resources
Study Start Date
May 2012 (undefined)
Primary Completion Date
August 2017 (Actual)
Study Completion Date
August 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Mclean Hospital
Collaborators
Brain & Behavior Research Foundation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Cannabis use disorders are an important public health problem in the United States, but no effective pharmacotherapies are available to treat these disorders. People with schizophrenia are more likely than healthy people to abuse cannabis. Cannabis use may worsen clinical outcomes in this group, making the identification of pharmacotherapy to treat cannabis dependence in those with schizophrenia important. The investigators intend to test the combination of dronabinol, a cannabinoid agonist, and the α2-adrenergic agonist clonidine, for cannabis dependence in subjects with schizophrenia. The combination of dronabinol and clonidine may alleviate cannabis withdrawal symptoms while allowing treatment-seeking outpatients to benefit from medical management (MM) sessions when they are trying to stop using cannabis. The investigators propose to assess the relationship of dronabinol and clonidine, when added to MM, on cannabis use patterns in cannabis-dependent patients with schizophrenia. Hypothesis: The investigators predict that combination pharmacotherapy of dronabinol and clonidine will significantly reduce cannabis use compared to those receiving placebo.
Detailed Description
Subjects will receive either the combination of dronabinol and clonidine or placebo in addition to medical management (MM) over a 10-week treatment period. Following treatment completion, subjects will have follow-up visits until 14 weeks after treatment initiation. This pilot study will evaluate the feasibility of the combination of dronabinol and clonidine for cannabis dependence and will establish effect sizes for a larger trial. Cannabis use disorders are highly prevalent in the United States and rising among high school seniors, making the identification of efficacious treatments for cannabis dependence of critical clinical and public health significance. Schizophrenia is overrepresented among those with cannabis dependence. At the completion of this study, the investigators hope to have improved our understanding of the relationship of the pharmacotherapy combination of dronabinol and clondine on cannabis use.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cannabis Dependence, Marijuana Dependence
Keywords
Cannabis Dependence, Marijuana Dependence, Cannabis Use Disorders, Cannabis Withdrawal, Dronabinol, Clonidine, Schizophrenia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dronabinol + Clonidine
Arm Type
Experimental
Arm Description
Dronabinol titrated to 5 mg three times daily, Clonidine 0.1 mg twice daily
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Dronabinol
Other Intervention Name(s)
Marinol, CSA Drug Code 7369, Schedule III, NDC 54868-3189-0
Intervention Description
Dronabinol titrated to 5 mg three times daily
Intervention Type
Drug
Intervention Name(s)
Clonidine
Other Intervention Name(s)
Catapres, NDC 16590-266-30
Intervention Description
Clonidine 0.1 mg twice daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
One placebo capsule by mouth twice daily
Primary Outcome Measure Information:
Title
Change From Baseline in Cannabis Use at 10 Weeks
Description
Subject self-report hits of marijuana per day at week 10
Time Frame
At 10 weeks
Secondary Outcome Measure Information:
Title
Change in Craving Symptoms From Baseline at 10 Weeks
Description
Scores on the Marijuana Craving Questionnaire (MCQ) (Heishman et al. 2009) - The 4 Factor Total Score. Maximum Score = 84 Minimum Score = 12 The higher the score, the more severe marijuana craving symptoms endorsed by the subject.
Time Frame
At 10 weeks
Title
Change From Baseline in Cannabis Use at 14 Weeks
Description
Self-report cannabis use at 14 weeks after initiating the study.
Time Frame
At 14 weeks
Title
Change in Craving Symptoms From Baseline at 14 Weeks
Description
Scores on the Marijuana Craving Questionnaire (Heishman et al. 2009) - The 4 Factor Total Score Maximum Score = 84 Minimum Score = 12 The higher the score, the more severe marijuana craving symptoms endorsed by the subject.
Time Frame
At 14 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age range 18-45 years DSM-IV diagnosis of cannabis dependence, based on the Structured Clinical Interview for DSM-IV (SCID) DSM-IV diagnosis of schizophrenia or schizoaffective disorder, based on the Structured Clinical Interview for DSM-IV (SCID) express a desire to quit cannabis use within the next 30 days have used cannabis on ≥20 days within the past 30 days (i.e., an average of ≥5 day per week) identify cannabis as their primary drug of abuse; 6) stable on antipsychotic medication for ≥1 month for women of childbearing age, a negative pregnancy test at screening with agreement to use adequate contraception to prevent pregnancy and monthly pregnancy tests consent for us to communicate with their prescribing clinician if one exists furnish the names of 2 locators, who would assist study staff in locating them during the study period live close enough to McLean Hospital to attend study visits plan to stay in the Boston area for the next 3 months are willing and able to sign informed consent. Exclusion Criteria: Current diagnosis of other drug or alcohol dependence (excluding nicotine) significant cardiac disease as indicated by history or suspected by abnormal ECG or history of cardiac symptoms Positive and Negative Syndrome Scale (PANSS) subscale for positive symptoms of psychosis item > 3 (moderate) at baseline evaluation current medical condition that could prevent regular study attendance liver function tests >3 times the upper limit of normal range history of seizure disorder or history of head trauma or CNS insult that could predispose the subject to seizures taking clozapine current suicidal risk bradycardia less than or equal to 50 bpm, supine blood pressure of less than or equal to 100/65, a seated blood pressure of less than or equal to 90/60, or orthostatic change of >20 systolic or >10 diastolic on standing, at screening or any pre-dose assessment, or symptoms attributable to low BP (i.e. lightheadedness or dizziness on standing) mental retardation or organic mental disorder currently in a residential treatment setting in which substance use is monitored and restricted, since the restricted access to drugs could represent an important confounding variable pregnant, nursing, or, if a woman of childbearing potential, not using a form of birth control judged by the investigator to be effective concomitant treatment with opioid analgesics, sedative hypnotics, or other known CNS depressants known hypersensitivity to cannabinoids or sesame oil or clonidine disease of the gastrointestinal system, liver, or kidneys that may impede metabolism or excretion of dronabinol inability to read or write in English that would hinder their ability to follow study procedures history of seizures or a family history of seizures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kevin P Hill, MD, MHS
Organizational Affiliation
Mclean Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
McLean Hospital
City
Belmont
State/Province
Massachusetts
ZIP/Postal Code
02478
Country
United States

12. IPD Sharing Statement

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Combination of Dronabinol and Clonidine for Cannabis Dependence in Patients With Schizophrenia

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