Psilocybin-Assisted vs Ketamine-Assisted Psychotherapy for Alcohol Use Disorder
Primary Purpose
Alcohol Use Disorder
Status
Not yet recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Psilocybin
Ketamine
Sponsored by
About this trial
This is an interventional basic science trial for Alcohol Use Disorder focused on measuring psilocybin, ketamine
Eligibility Criteria
Inclusion Criteria:
- English fluency
- Meets criteria for DSM-V Alcohol Use Disorder (AUD)
- Have at least 4 heavy drinking days in the past 30 days
- Not currently participating in formal treatment for alcohol dependence
- At least a high-school level of education or equivalent (e.g. GED).
- Currently using an effective method of contraception (females).
- Family member/friend for pick-up, overnight post-psilocybin session monitoring.
- Agree to maintain normal caffeine intake (coffee, tea) on day of psilocybin session. No caffeine use on day of session if not routinely used.
- Agree not to take any "as needed" medications on the mornings of drug sessions
- Agree not to take sildenafil (Viagra®), tadalafil, or similar medications within 72 hours of each drug administration.
Exclusion Criteria:
- Pregnant or lactating
- Drug/medication assessment that yields: nonprescription medication use, nutritional supplement, or herbal supplement (except when approved by the study investigators), medically unstable, psychoactive drug use (including nicotine) within 24 hours of drug administration (the exception is caffeine), current medication use that has significant potential to interact with study drug (e.g., antidepressants, antipsychotics, psychostimulants, treatments for addictions, other dopaminergic or serotonergic agents, lithium, anticonvulsants)
- Psychiatric assessment that yields: increased risk of suicidality, family history of schizophrenia or schizoaffective disorder (first or second degree relatives), or bipolar disorder type 1 (first degree relatives), hallucinogen use disorder (or any use in the past 1 year, or >25 lifetime uses), cocaine, psychostimulant, opioid, or cannabis use disorder within past 12 months and/or any use within past 30 days, co-occurring psychiatric conditions: (i.e. schizophrenia, schizoaffective disorder, bipolar disorder, current major depressive episode, current post-traumatic stress disorder, current suicidality or history of medically serious suicide attempt), high risk of adverse emotional or behavioral reaction based on investigator's clinical evaluation (e.g., evidence of serious personality disorder, antisocial behavior, serious current stressors, lack of meaningful social support).
- Medical assessment that yields: serious ECG abnormalities (evidence of ischemia, myocardial infarction, QTc prolongation, etc.), serious abnormalities of complete blood count or chemistries, medical conditions that would preclude safe participation per investigator (seizure disorder, significantly impaired liver function, coronary artery disease, heart failure, uncontrolled hypertension, history of cerebrovascular accident, asthma, significant alcohol withdrawal history, etc.).
- MRI contraindication (pacemaker, copper IUD, etc.)
Sites / Locations
- University of Iowa
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Psilocybin Group (Arm 1)
Ketamine Group (Arm 2)
Arm Description
receives individual psychotherapy sessions plus a (25 mg) psilocybin session.
receives individual psychotherapy sessions plus a (200 mg) ketamine session with open-label access option at the end of their study involvement.
Outcomes
Primary Outcome Measures
Timeline Follow-Back for Alcohol to assess change
quantifies daily alcohol use
Secondary Outcome Measures
T1rho
Measures biological changes in the brain
Resting state fMRI
Measures biological changes in the brain
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05421065
Brief Title
Psilocybin-Assisted vs Ketamine-Assisted Psychotherapy for Alcohol Use Disorder
Official Title
Psilocybin-Assisted vs Ketamine-Assisted Psychotherapy for Alcohol Use Disorder
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 2023 (Anticipated)
Primary Completion Date
October 2024 (Anticipated)
Study Completion Date
October 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Peggy C Nopoulos
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This pilot study will collect preliminary data that measures the effects of psilocybin-assisted psychotherapy vs ketamine-assisted psychotherapy on patients struggling with alcohol use.
Detailed Description
This pilot study will be a double blind, randomized, active-comparator controlled trial with two study arms. Subjects randomized to Arm 1 (n=10) will receive individual psychotherapy sessions plus a 25mg dose of psilocybin, while Arm 2 subjects (n=10) will receive individual psychotherapy sessions and a 200mg dose of ketamine. Psychotherapy sessions will involve integrative psychotherapy modalities.
At baseline, subjects will be consented, randomized into one of the two arms, complete psychiatric and medical evaluations, and will undergo an MRI scan. The first two therapy sessions (week 1 and week 2) will be used to learn about the participant's life story, engage the patient, and evoke their reasons for wanting to change their pattern of alcohol use. At week 3, participants will undergo a psilocybin-assisted therapy session or a ketamine-assisted therapy session. The last 2 psychotherapy sessions will be focused on integration of their experiences in the drug administration session and will include a second MRI scan and more assessments. Therefore, each arm receives 4 psychotherapy sessions, and the primary difference between the groups is which drug participants receive. After the psychotherapy sessions are completed at the end of week 4, subjects will be followed weekly for 4 weeks. At the last follow-up (week 8), they will undergo a third MRI scan and a final assessment. At the conclusion of the study, those randomized to the ketamine group will be offered a psilocybin-assisted therapy session, and two follow-up/integration sessions in an open-label extension. The open-label extension will also include an additional 4 weeks of follow-up.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcohol Use Disorder
Keywords
psilocybin, ketamine
7. Study Design
Primary Purpose
Basic Science
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Psilocybin Group (Arm 1)
Arm Type
Experimental
Arm Description
receives individual psychotherapy sessions plus a (25 mg) psilocybin session.
Arm Title
Ketamine Group (Arm 2)
Arm Type
Active Comparator
Arm Description
receives individual psychotherapy sessions plus a (200 mg) ketamine session with open-label access option at the end of their study involvement.
Intervention Type
Drug
Intervention Name(s)
Psilocybin
Intervention Description
1 25mg oral dose
Intervention Type
Drug
Intervention Name(s)
Ketamine
Intervention Description
1 200mg oral dose
Primary Outcome Measure Information:
Title
Timeline Follow-Back for Alcohol to assess change
Description
quantifies daily alcohol use
Time Frame
weekly, over the course of 8 weeks
Secondary Outcome Measure Information:
Title
T1rho
Description
Measures biological changes in the brain
Time Frame
three times (before intervention, immediately after intervention, and 4 weeks-post intervention)
Title
Resting state fMRI
Description
Measures biological changes in the brain
Time Frame
three times (before intervention, immediately after intervention, and 4 weeks-post intervention)
Other Pre-specified Outcome Measures:
Title
Feasibility and acceptability of the protocol
Description
Measure study's rate of attrition by recording the number of participants who withdraw from the study or are discharged from the study before completion
Time Frame
1 year
Title
Feasibility and acceptability of the protocol
Description
Measure frequency and nature of adverse events (AEs) through recording total number of AEs and their severity on a scale of mild to moderate to severe (1-3 scale with 3 being the worst outcome)
Time Frame
1 year
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
English fluency
Meets criteria for DSM-V moderate to severe Alcohol Use Disorder (AUD)
Have at least 4 heavy drinking days in the past 30 days
Not currently participating in formal treatment for alcohol dependence
No history of a of cerebrovascular accident, asthma, or significant alcohol withdrawal history
No seizure disorder, coronary artery disease, heart failure, uncontrolled hypertension, insulin-dependent diabetes
At least a high-school level of education or equivalent (e.g. GED)
Family member/friend for pick-up, overnight post-drug session monitoring
Psilocybin and ketamine naïve
No self-reported, personal, or familial history of specific psychotic disorders/episodes
No serious traumatic brain injury (TBI) in the past 2 years
No known allergies to diazepam (rescue medication)
Weight between 50kg and 150 kg
Exclusion Criteria:
Drug/medication assessment that yields: nonprescription medication use, nutritional supplement, or herbal supplement (except when approved by the study investigators), medically unstable, current medication use that has significant potential to interact with study drug (e.g., antidepressants, antipsychotics, psychostimulants, treatments for addictions, other dopaminergic or serotonergic agents, lithium, anticonvulsants, or benzodiazepines).
Psychiatric assessment that yields:1) history of severe suicide attempt, 2) current suicidality 3) first degree relative with schizophrenia or schizoaffective disorder, 4) comorbid substance use including cocaine, psychostimulant, or opioid use disorder within past 12 months and/or any use within past 30 days, 5) history of co-occurring psychotic episode/diagnosis including schizophrenia, schizoaffective disorder, schizophreniform, substance-induced psychosis, delusional disorder, or psychosis not otherwise specified, 6) high risk of adverse emotional or behavioral reaction based on the medical monitor's clinical evaluation that may also yield evidence of serious current stressors, a lack of meaningful social support, antisocial behavior, and/or serious personality disorders amongst other conditions.
Medical assessment that yields: serious ECG abnormalities (evidence of ischemia, myocardial infarction, QTc prolongation [QTc > .045]), serious abnormalities of complete blood count or chemistries, medical conditions that would preclude safe participation (significantly impaired liver function).
MRI contraindication (pacemaker, etc.)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Peggy C Nopoulos, MD
Phone
319-356-1144
Email
peggy-nopoulos@uiowa.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Lindsay E Golden
Email
lindsay-golden@uiowa.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peggy C Nopoulos, MD
Organizational Affiliation
University of Iowa
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lindsay E Golden
Email
lindsay-golden@uiowa.edu
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
33146667
Citation
Davis AK, Barrett FS, May DG, Cosimano MP, Sepeda ND, Johnson MW, Finan PH, Griffiths RR. Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2021 May 1;78(5):481-489. doi: 10.1001/jamapsychiatry.2020.3285. Erratum In: JAMA Psychiatry. 2021 Feb 10;:
Results Reference
background
PubMed Identifier
25586396
Citation
Bogenschutz MP, Forcehimes AA, Pommy JA, Wilcox CE, Barbosa PC, Strassman RJ. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. J Psychopharmacol. 2015 Mar;29(3):289-99. doi: 10.1177/0269881114565144. Epub 2015 Jan 13.
Results Reference
background
PubMed Identifier
18593734
Citation
Johnson M, Richards W, Griffiths R. Human hallucinogen research: guidelines for safety. J Psychopharmacol. 2008 Aug;22(6):603-20. doi: 10.1177/0269881108093587. Epub 2008 Jul 1.
Results Reference
background
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Psilocybin-Assisted vs Ketamine-Assisted Psychotherapy for Alcohol Use Disorder
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