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Progesterone Treatment for Cocaine-dependent Women: A Pilot Study (PROG)

Primary Purpose

Cocaine Dependence

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Oral micronized progesterone
Placebo
Sponsored by
New York State Psychiatric Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cocaine Dependence focused on measuring cocaine, treatment, progesterone

Eligibility Criteria

18 Years - 60 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • 1. Women between the ages of 18-60 who meet criteria for current cocaine dependence (DSM-IV-TR). Volunteers may meet criteria for abuse or dependence on nicotine, marijuana or alcohol, as long as the dependence is secondary to cocaine dependence and does not require any medical intervention (see additional exclusions for alcohol dependence below).

    2. Use cocaine by the smoked or intranasal route at least four days in the past month, with at least weekly cocaine use.

    3. Women with regular menstrual cycles (24-45 days) who are not pregnant, based on the results of a blood pregnancy test drawn at the time of screening. They must agree to use a barrier method of contraception with proven efficacy and agree not to become pregnant during the study. To confirm this, urine pregnancy tests will be conducted weekly.

    4. Women must be capable of giving informed consent and capable of complying with study procedures.

Exclusion Criteria:

  • 1. Meets DSM-IV-TR criteria for bipolar disorder, Schizophrenia, or any psychotic disorder other than transient psychosis due to drug abuse.

    2. Individuals with any current Axis I psychiatric disorder as defined by DSM-IV-TR supported by the SCID-I/P that in the investigator's judgment are unstable or would be disrupted by study medication. Disorders that are stable on psychotherapy or pharmacotherapy will not be exclusionary. Individuals will be permitted to take prescribed zolpidem and zaleplon or other medications for insomnia if there is no evidence of dependence on these substances.

    3. Individuals with current major depressive disorder.

    4. Individuals physiologically dependent on any other drugs (excluding nicotine or cannabis) that require medical intervention will be excluded and referred for treatment. Individuals with severe alcohol dependence , even without physiological dependence, or with any known alcohol-related diseases will also be excluded.

    5. Females who have any of the following medical contraindications: undiagnosed abnormal genital bleeding, known or suspected history of breast or genital cancer, active deep vein thrombosis, pulmonary embolism, or history of these conditions, active or recent (within last year) arterial thromboembolic diseases (e.g., stroke, myocardial infarction), liver dysfunction.

    6. Females who are cognitively impaired or have a chronic organic mental disorder.

    7. Individuals with current suicidal risk.

    8. Individuals with coronary vascular disease as indicated by history or suspected by abnormal ECG or history of cardiac symptoms.

    9. Unstable physical disorders which might make participation hazardous such as uncontrolled hypertension (Blood pressure > 150/ 90, or Heart Rate > 100 when sitting quietly), acute hepatitis (patients with chronic mildly elevated transaminases < 3x upper limit of normal are acceptable), or uncontrolled diabetes.

    10. Individuals with a history of seizures.

    11. Women who are pregnant or nursing.

    12. Individuals who are legally mandated (e.g., to avoid incarceration, monetary or other penalties, etc.) to participate in substance abuse treatment program.

    13. Females with a known or suspected hypersensitivity to oral micronized progesterone.

Sites / Locations

  • New York State Psychiatric Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Oral micronized progesterone

Arm Description

matched placebo

Oral micronized progesterone (up to 400 mg/day)

Outcomes

Primary Outcome Measures

Cocaine Abstinence Based on Urine Toxicology Results
Percentage of patients cocaine abstinent during last 3 weeks of the study (weeks 7-9)

Secondary Outcome Measures

Full Information

First Posted
March 6, 2008
Last Updated
April 9, 2014
Sponsor
New York State Psychiatric Institute
Collaborators
National Institute on Drug Abuse (NIDA)
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1. Study Identification

Unique Protocol Identification Number
NCT00632099
Brief Title
Progesterone Treatment for Cocaine-dependent Women: A Pilot Study
Acronym
PROG
Official Title
Progesterone Treatment for Cocaine-dependent Women: A Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
April 2014
Overall Recruitment Status
Completed
Study Start Date
February 2008 (undefined)
Primary Completion Date
September 2012 (Actual)
Study Completion Date
September 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
New York State Psychiatric Institute
Collaborators
National Institute on Drug Abuse (NIDA)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this pilot treatment trial is to evaluate the efficacy of oral micronized PROG in cocaine-dependent women. Since we have shown (Evans & Foltin, 2006) that oral micronized PROG attenuates the positive subjective effects of smoked cocaine in females, but not in males, and we have preliminary data indicating that oral micronized PROG also reduces smoked cocaine self-administration in the laboratory, PROG appears to be an ideal potential candidate medication to evaluate in cocaine-dependent women. Prior to randomization to treatment, women will reside inpatient for one week to ensure cocaine abstinence since one of the primary outcome measures will be time to cocaine relapse.
Detailed Description
Primary Aims: The primary aims will be directed at treatment efficacy. Relatively unique to cocaine treatment trials, one of the principal outcome measures will be time to cocaine relapse. We hypothesize that maintenance on PROG will increase the time to cocaine relapse compared to maintenance on placebo (PBO). Another cocaine-related efficacy endpoint will be the proportion of patients who achieve at least 2 consecutive weeks of cocaine abstinence (based on urine toxicology results) during the double-blind treatment phase. Lastly, the proportion of cocaine-negative urines collected throughout the treatment trial will be measured. We hypothesize that women in the PROG group will show a greater reduction in cocaine use compared to those in the PBO group. Secondary Aims: 1) Determine if response to laboratory stressors will predict treatment outcome. We hypothesize that those women with the greatest stress response will do worse in treatment and that maintenance on PROG will reduce stress/anxiety and thereby improve treatment outcome. 2) Determine if treatment retention is better in the PROG group compared to the PBO group and determine if maintenance on PROG improves overall functioning compared to maintenance on PBO based on the Clinical Global Inventory (CGI). We hypothesize that women in the PROG group will have better treatment retention and improvement in CGI scores compared to women in the PBO group. Tertiary Aims: To conduct exploratory analyses to determine whether 1) trauma history is related to treatment outcomes and 2) improvements in treatment outcome measures are related to decreases in HIV high-risk behaviors.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cocaine Dependence
Keywords
cocaine, treatment, progesterone

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
matched placebo
Arm Title
Oral micronized progesterone
Arm Type
Experimental
Arm Description
Oral micronized progesterone (up to 400 mg/day)
Intervention Type
Drug
Intervention Name(s)
Oral micronized progesterone
Other Intervention Name(s)
Progesterone
Intervention Description
Oral micronized progesterone (up to 400 mg/day), suspended in olive oil
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
matched placebo
Primary Outcome Measure Information:
Title
Cocaine Abstinence Based on Urine Toxicology Results
Description
Percentage of patients cocaine abstinent during last 3 weeks of the study (weeks 7-9)
Time Frame
during last 3 weeks of the trial

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Women between the ages of 18-60 who meet criteria for current cocaine dependence (DSM-IV-TR). Volunteers may meet criteria for abuse or dependence on nicotine, marijuana or alcohol, as long as the dependence is secondary to cocaine dependence and does not require any medical intervention (see additional exclusions for alcohol dependence below). 2. Use cocaine by the smoked or intranasal route at least four days in the past month, with at least weekly cocaine use. 3. Women with regular menstrual cycles (24-45 days) who are not pregnant, based on the results of a blood pregnancy test drawn at the time of screening. They must agree to use a barrier method of contraception with proven efficacy and agree not to become pregnant during the study. To confirm this, urine pregnancy tests will be conducted weekly. 4. Women must be capable of giving informed consent and capable of complying with study procedures. Exclusion Criteria: 1. Meets DSM-IV-TR criteria for bipolar disorder, Schizophrenia, or any psychotic disorder other than transient psychosis due to drug abuse. 2. Individuals with any current Axis I psychiatric disorder as defined by DSM-IV-TR supported by the SCID-I/P that in the investigator's judgment are unstable or would be disrupted by study medication. Disorders that are stable on psychotherapy or pharmacotherapy will not be exclusionary. Individuals will be permitted to take prescribed zolpidem and zaleplon or other medications for insomnia if there is no evidence of dependence on these substances. 3. Individuals with current major depressive disorder. 4. Individuals physiologically dependent on any other drugs (excluding nicotine or cannabis) that require medical intervention will be excluded and referred for treatment. Individuals with severe alcohol dependence , even without physiological dependence, or with any known alcohol-related diseases will also be excluded. 5. Females who have any of the following medical contraindications: undiagnosed abnormal genital bleeding, known or suspected history of breast or genital cancer, active deep vein thrombosis, pulmonary embolism, or history of these conditions, active or recent (within last year) arterial thromboembolic diseases (e.g., stroke, myocardial infarction), liver dysfunction. 6. Females who are cognitively impaired or have a chronic organic mental disorder. 7. Individuals with current suicidal risk. 8. Individuals with coronary vascular disease as indicated by history or suspected by abnormal ECG or history of cardiac symptoms. 9. Unstable physical disorders which might make participation hazardous such as uncontrolled hypertension (Blood pressure > 150/ 90, or Heart Rate > 100 when sitting quietly), acute hepatitis (patients with chronic mildly elevated transaminases < 3x upper limit of normal are acceptable), or uncontrolled diabetes. 10. Individuals with a history of seizures. 11. Women who are pregnant or nursing. 12. Individuals who are legally mandated (e.g., to avoid incarceration, monetary or other penalties, etc.) to participate in substance abuse treatment program. 13. Females with a known or suspected hypersensitivity to oral micronized progesterone.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Suzette Evans, PhD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
New York State Psychiatric Institute
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
36095308
Citation
Oliva A, Reed SC, Brooks DJ, Levin FR, Evans SM. Safety and tolerability of progesterone treatment for women with cocaine use disorder: a pilot treatment trial. Am J Drug Alcohol Abuse. 2022 Sep 3;48(5):586-595. doi: 10.1080/00952990.2022.2114004. Epub 2022 Sep 12.
Results Reference
derived
Links:
URL
http://www.stars.columbia.edu/
Description
Substance Treatment and Research Service of Columbia University

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Progesterone Treatment for Cocaine-dependent Women: A Pilot Study

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