Cocaine Dependence Clinical Trial
Official title:
Effectiveness of Disulfiram for Treating Cocaine Dependence in Individuals With Different Dopamine Beta Hydroxylase (DBH) Genes
Previous research has shown that disulfiram, a medication sometimes used for treating alcoholism, discourages cocaine use among cocaine addicts who are undergoing methadone treatment. By blocking the enzyme dopamine beta hydroxylase (DBH), disulfiram increases levels of dopamine and produces an unpleasant sense of hyperstimulation and discomfort in cocaine users. This study will evaluate the effectiveness of disulfiram in preventing drug relapse among cocaine and opiate addicts with varying inherited levels of DBH.
Dopamine, a type of neurotransmitter, is the brain's "feel good" chemical. The amount of
dopamine in the body may be an important factor in how cocaine addicts respond to treatment.
Disulfiram, like cocaine, enhances dopamine activity. Upon taking disulfiram, subsequent
intake of cocaine may elevate dopamine to excessive levels that produce extreme discomfort.
DBH is an enzyme that breaks down dopamine. A particular variation in the DBH gene can
affect the amount of dopamine that is released in the body. Therefore, cocaine addicts with
varying DBH genes may respond differently to treatment. The purpose of this study is to
compare the effectiveness of disulfiram in preventing relapse among methadone-maintained
individuals addicted to both cocaine and opioids who may have different DBH genes.
This 17-week study will begin with a 2-week methadone stabilization period. Participants
will then be randomly assigned to receive a daily dose of either 250 mg of disulfiram or
placebo for 12 weeks, while concurrently receiving methadone treatment. All participants
will stop receiving study medication at Week 14, at which point they will undergo a 4-week
methadone detoxification period. Participants will report cocaine and other drug use, as
well as any cocaine cravings that they experience. Cocaine levels will be monitored
throughout the study with urine tests. The DBH gene of each participant will be examined to
determine its specific make-up and any particular variations.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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