Alcoholism Clinical Trial
Official title:
A Phase II, Double-blind, Placebo-Controlled, Pilot Trial of the Combination of Modafinil and Naltrexone for the Treatment of Cocaine and Alcohol Dependence
Modafinil is a medication that may enhance mood and increase energy in cocaine addicts, which may be useful in preventing cocaine relapse. Naltrexone is a medication that is currently used to treat drug and alcohol addiction. A combination of these two medications may be beneficial in reducing drug and alcohol use in individuals undergoing substance abuse treatment. The purpose of this study is to evaluate the effectiveness of modafinil and naltrexone, alone and in combination, at reducing drug and alcohol use in individuals addicted to cocaine and alcohol.
Cocaine and alcohol addiction are serious health problems with no available medical treatment
for preventing relapse. Past research has shown that individuals who are addicted to both
cocaine and alcohol typically respond poorly to conventional substance abuse treatment.
Little attention has been directed towards how best to treat these individuals. Naltrexone is
a medication that is currently used to treat drug and alcohol addiction. It acts by blocking
the "high" feeling produced by drugs and alcohol. Modafinil, another medication, enhances
mood, increases energy, and improves concentration in people with narcolepsy. Preliminary
research has shown that it may produce similar effects to cocaine, thereby potentially
countering the symptoms of cocaine withdrawal. Cognitive Behavioral Coping Skills Therapy
(CBT), a form of therapy that aims to alter an individual's patterns of behavior and drug
use, is also an important component of substance abuse treatment. The purpose of this study
is to compare the effectiveness of CBT plus placebo, CBT plus modafinil, CBT plus naltrexone,
and CBT plus a combination of modafinil and naltrexone at reducing cocaine and alcohol use in
individuals addicted to both substances.
This 14-week study will enroll individuals addicted to both cocaine and alcohol. During a
1-week screening period, potential participants will be required to complete a detoxification
program, including stopping all cocaine and alcohol use. Participants will also undergo a
physical exam and an electrocardiogram. Blood will be drawn for laboratory tests, and urine
tests will be used to screen for the presence of drugs and alcohol. Individuals who complete
the screening and meet all study requirements will be permitted to participate in the
treatment phase of the study. During the 13-week treatment phase, participants will be
randomly assigned to receive modafinil, naltrexone, a combination of modafinil and
naltrexone, or placebo. All participants will attend a CBT session once a week. Study visits
will take place twice a week. At each visit, a urine test and breathalyzer will be used to
screen for the presence of alcohol and drugs. Participants will also complete standardized
psychological questionnaires to measure drug and alcohol craving, treatment services
received, severity of illness, and withdrawal symptoms. In addition, participants will meet
weekly with a nurse practitioner, who will dispense study medications, monitor adverse
events, and evaluate the participant's clinical status. A follow-up evaluation will occur 6
months following the end of treatment.
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