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Study of Droxidopa Treatment in Adults With Attention Deficit Hyperactivity Disorder With Co-administration of Carbidopa (ADD201)

Primary Purpose

Attention Deficit Hyperactivity Disorder

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Droxidopa+Carbidopa
Placebo
Sponsored by
Chelsea Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Attention Deficit Hyperactivity Disorder focused on measuring Attention Deficit Hyperactivity Disorder, ADHD, Adult ADHD, Adult Attention Deficit Hyperactivity Disorder

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. At the time of consent, are between the ages of 18-55, inclusive.
  2. Meet DSM-IV criteria for ADHD as assessed by the Adult ADHD Clinician Diagnostic Scale (ACDS) v1.2.
  3. Concomitant Axis I diagnoses that are allowed include social anxiety disorder or dysthymia which does not require treatment. Psychiatric co-morbidities will be diagnosed with the SCID.
  4. Must have a satisfactory medical assessment with no clinically significant abnormalities as determined by medical history, physical exam, ECG, and clinical laboratory testing.
  5. Must be able to swallow capsules.
  6. In the opinion of the investigator, the subject must understand and be able, willing and likely to fully comply with the study procedures and restrictions.
  7. Must have given signed and dated informed consent in accordance with Good Clinical Practice (GCP) Guidelines.

Exclusion Criteria:

  1. Lifetime or present history of bipolar or psychotic disorders, that in the investigator's opinion, interfere with the diagnosis and/or with the conduct of the study.
  2. Uncontrolled comorbid major depressive disorder, anxiety disorder or dysthymia.
  3. Women of childbearing potential who are not using a medically accepted contraception.
  4. Sexually active males whose partner is a WOCP must agree to use condoms for the duration of the study and for 4 weeks after the last dose.
  5. Women who are pregnant, breast feeding, or plan to become pregnant during the course of this study.
  6. Clinically significant electrocardiogram or laboratory abnormalities at screening that are deemed exclusionary in the opinion of the Principal Investigator.
  7. Subjects taking any psychotropic medication on a regular basis. Subjects will need to be free of all psychotropic medications (one week for psychostimulants, four weeks for all other medications), except for PRN benzodiazepines or hypnotics. Allowed psychiatric co-morbidities include social anxiety disorder or dysthymia which does not require treatment.
  8. Subjects with any concurrent chronic or acute illness or unstable medical condition that could, in the opinion of the study physician, confound the results of safety assessments, increase risk to the subject or lead to difficulty complying with the protocol. Subjects who have a history of mental retardation or severe learning disability will be excluded.
  9. Subjects who in the investigator's opinion meet any of the exclusionary criteria specified on the FDA label of either Droxidopa or carbidopa.
  10. Have uncontrolled hypertension, defined as systolic blood pressure >140 mmHg and/or diastolic blood pressure >110 mmHg or use of ≥2 antihypertensive medications.
  11. Known or suspected hypersensitivity to the study medication or any of its ingredients.
  12. Have in the investigator's opinion any significant cardiac arrhythmia.
  13. Any significant systemic, hepatic, cardiac or renal illness.
  14. Diabetes mellitus or insipidus.
  15. Have a history of closed angle glaucoma.
  16. Have a known or suspected current malignancy. Patients with a history of cancer must be symptom- and treatment-free for at least 5 years prior to randomization, with the exception of patients with non-melanoma, non-invasive skin cancers (such as basal cell carcinoma), who should not have had an intervention or recurrence within one year of starting the study.
  17. Subjects with known gastrointestinal illness or other gastrointestinal disorder that may, in the investigator's opinion, affect the absorption of study drug.
  18. In the investigator's opinion, have clinically significant abnormalities on clinical examination or laboratory testing.
  19. In the investigator's opinion, are unable to adequately co-operate because of individual or family situation.
  20. Are not able or willing to comply with the study requirements for the duration of the study.
  21. Have participated in another clinical trial with an investigational agent (including named patient or compassionate use protocol) within 1 month before the start of the study.
  22. Previous enrollment in the study.

Sites / Locations

  • VA New York Harbor Healthcare System/New York University Langone Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Droxidopa+Carbidopa

Placebo

Arm Description

Droxidopa (L-dihydroxyphenylserine (L-DOPS)) (200, 400, or 600mgs TID) in combination with carbidopa (25mg or 50mg TID)

Placebo

Outcomes

Primary Outcome Measures

The primary outcome measure will be changes from baseline in total score on the Adult ADHD Investigator Symptom Rating Scale (AISRS).

Secondary Outcome Measures

Changes in self-report ADHD symptoms on the ASRS v1.1 Symptom Checklist
Changes in global impairment on the Clinician Global Impression Scale (CGI).

Full Information

First Posted
September 23, 2009
Last Updated
March 27, 2013
Sponsor
Chelsea Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT00983814
Brief Title
Study of Droxidopa Treatment in Adults With Attention Deficit Hyperactivity Disorder With Co-administration of Carbidopa
Acronym
ADD201
Official Title
A Two-Period Trial (Open-Label and Randomized Placebo-Controlled Substitution) of Droxidopa Treatment in Adults With ADHD With Co-administration of Carbidopa
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Completed
Study Start Date
October 2009 (undefined)
Primary Completion Date
May 2011 (Actual)
Study Completion Date
July 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chelsea Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological disorder characterized by lifelong issues of inattention, distraction, organizational difficulties, forgetfulness, restlessness, talking out of turn, difficulty waiting and interrupting others. ADHD is the second most common neuropsychiatric disorder affecting 4.4% of the US adult population, or between 8-9 million individuals (Kessler et al., 2006). Droxidopa (L-dihydroxyphenylserine (L-DOPS)) is a synthetic catecholamine which is converted to norepinephrine (NE) via decarboxylation, resulting in increased levels of NE centrally in the CNS and peripherally. Co-treatment with carboxylase inhibitors, such as carbidopa, given with droxidopa, can increase the CNS levels of NE with greater crossing of the blood-brain barrier. Droxidopa has received orphan drug approval by the FDA for the treatment of symptomatic neurogenic orthostatic hypotension in individuals with primary autonomic failure. The half-life of droxidopa is approximately 2-3 hours, resulting in administration thee times daily. As adult ADHD is characterized as a disorder of decreased NE activity in the pre-frontal cortex, it is hypothesized that treating patients with droxidopa (in co-administration of carbidopa) will have a positive effect on adult ADHD.
Detailed Description
This will be a 12-week study of twenty enrolled subjects with DSM IV adult ADHD (age 18-55), with a goal of completing twenty subjects in the trial. The primary objective of this study is to determine the effect of droxidopa therapy on adult ADHD symptoms over the course of a six-week open-label titration period followed by a two-week double-blind, placebo-controlled period. The primary outcome measure will be changes from baseline in total score on the Adult ADHD Investigator Symptom Rating Scale (AISRS). Secondary measures will be changes in self-report ADHD symptoms on the ASRS v1.1 Symptom Checklist, global impairment on the Clinician Global Impression Scale (CGI).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Attention Deficit Hyperactivity Disorder
Keywords
Attention Deficit Hyperactivity Disorder, ADHD, Adult ADHD, Adult Attention Deficit Hyperactivity Disorder

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Droxidopa+Carbidopa
Arm Type
Experimental
Arm Description
Droxidopa (L-dihydroxyphenylserine (L-DOPS)) (200, 400, or 600mgs TID) in combination with carbidopa (25mg or 50mg TID)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Droxidopa+Carbidopa
Other Intervention Name(s)
Droxidopa, L-threo-dihydroxyphenylserine, L-DOPS
Intervention Description
Droxidopa (L-dihydroxyphenylserine (L-DOPS)) (200, 400, or 600mgs TID) in combination with carbidopa (25mg or 50mg TID, provided as oral capsules taken TID from Baseline to end of Week 8
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo matched oral capsules taken TID from Baseline to end of Week 8
Primary Outcome Measure Information:
Title
The primary outcome measure will be changes from baseline in total score on the Adult ADHD Investigator Symptom Rating Scale (AISRS).
Time Frame
Baseline to end of week 8 treatment
Secondary Outcome Measure Information:
Title
Changes in self-report ADHD symptoms on the ASRS v1.1 Symptom Checklist
Time Frame
baseline to end of 8 Week treatment period
Title
Changes in global impairment on the Clinician Global Impression Scale (CGI).
Time Frame
baseline to end of week 8 treatment period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: At the time of consent, are between the ages of 18-55, inclusive. Meet DSM-IV criteria for ADHD as assessed by the Adult ADHD Clinician Diagnostic Scale (ACDS) v1.2. Concomitant Axis I diagnoses that are allowed include social anxiety disorder or dysthymia which does not require treatment. Psychiatric co-morbidities will be diagnosed with the SCID. Must have a satisfactory medical assessment with no clinically significant abnormalities as determined by medical history, physical exam, ECG, and clinical laboratory testing. Must be able to swallow capsules. In the opinion of the investigator, the subject must understand and be able, willing and likely to fully comply with the study procedures and restrictions. Must have given signed and dated informed consent in accordance with Good Clinical Practice (GCP) Guidelines. Exclusion Criteria: Lifetime or present history of bipolar or psychotic disorders, that in the investigator's opinion, interfere with the diagnosis and/or with the conduct of the study. Uncontrolled comorbid major depressive disorder, anxiety disorder or dysthymia. Women of childbearing potential who are not using a medically accepted contraception. Sexually active males whose partner is a WOCP must agree to use condoms for the duration of the study and for 4 weeks after the last dose. Women who are pregnant, breast feeding, or plan to become pregnant during the course of this study. Clinically significant electrocardiogram or laboratory abnormalities at screening that are deemed exclusionary in the opinion of the Principal Investigator. Subjects taking any psychotropic medication on a regular basis. Subjects will need to be free of all psychotropic medications (one week for psychostimulants, four weeks for all other medications), except for PRN benzodiazepines or hypnotics. Allowed psychiatric co-morbidities include social anxiety disorder or dysthymia which does not require treatment. Subjects with any concurrent chronic or acute illness or unstable medical condition that could, in the opinion of the study physician, confound the results of safety assessments, increase risk to the subject or lead to difficulty complying with the protocol. Subjects who have a history of mental retardation or severe learning disability will be excluded. Subjects who in the investigator's opinion meet any of the exclusionary criteria specified on the FDA label of either Droxidopa or carbidopa. Have uncontrolled hypertension, defined as systolic blood pressure >140 mmHg and/or diastolic blood pressure >110 mmHg or use of ≥2 antihypertensive medications. Known or suspected hypersensitivity to the study medication or any of its ingredients. Have in the investigator's opinion any significant cardiac arrhythmia. Any significant systemic, hepatic, cardiac or renal illness. Diabetes mellitus or insipidus. Have a history of closed angle glaucoma. Have a known or suspected current malignancy. Patients with a history of cancer must be symptom- and treatment-free for at least 5 years prior to randomization, with the exception of patients with non-melanoma, non-invasive skin cancers (such as basal cell carcinoma), who should not have had an intervention or recurrence within one year of starting the study. Subjects with known gastrointestinal illness or other gastrointestinal disorder that may, in the investigator's opinion, affect the absorption of study drug. In the investigator's opinion, have clinically significant abnormalities on clinical examination or laboratory testing. In the investigator's opinion, are unable to adequately co-operate because of individual or family situation. Are not able or willing to comply with the study requirements for the duration of the study. Have participated in another clinical trial with an investigational agent (including named patient or compassionate use protocol) within 1 month before the start of the study. Previous enrollment in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lenard A Adler, M.D.
Organizational Affiliation
VA New York Harbor Healthcare System/New York University Langone Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
VA New York Harbor Healthcare System/New York University Langone Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10010
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
25907673
Citation
Adler LA, Gorny SW. Pilot Study of Droxidopa With Carbidopa in Adults With ADHD. J Atten Disord. 2019 Jan;23(2):189-198. doi: 10.1177/1087054715580393. Epub 2015 Apr 23.
Results Reference
derived

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Study of Droxidopa Treatment in Adults With Attention Deficit Hyperactivity Disorder With Co-administration of Carbidopa

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