Nicotine Dependence Clinical Trial
Official title:
A 24-week Open-Label Feasibility Trial of Varenicline for Alcoholic Cigarette Smokers
The overall hypothesis of this line of research is that varenicline will decrease alcohol consumption and tobacco use and will increase alcohol and tobacco abstinence rates. In order to explore this hypothesis, the investigators will conduct a two-phase study: 1) an open label pilot study investigating the effect of varenicline on reduction of and abstinence from alcohol and tobacco; and 2) an optional MR spectroscopy to investigate whether glutamate and other brain metabolites correlate to measures of alcohol craving severity and/or subsequent varenicline treatment response.
The goal of this proposal is to explore the potential efficacy of varenicline for reducing
alcohol consumption among alcohol-dependent cigarette smokers. The hypothesis for the current
study is that 24 weeks of varenicline will increase alcohol abstinence rates among smokers
and decrease alcohol consumption among patients receiving inpatient addiction treatment for
alcoholism. The investigators will also explore whether varenicline has a beneficial effect
on tobacco abstinence rates in this population of tobacco users.
The investigators will conduct an open-label pilot study to determine clinical efficacy and
employ neuroimaging techniques to evaluate how glutamate and other brain metabolites
correlate to measures of alcohol craving severity and/or subsequent varenicline treatment
response. The investigators will enroll 20 subjects receiving treatment in the Mayo Clinic
Inpatient Addictions Program (IAP) and compare outcomes with patients participating in a
similar 6-month open-label study of acamprosate.
The Primary aims of this study are:
1. To obtain preliminary evidence of efficacy of varenicline (0.5 mg once daily for 3 days,
0.5 mg twice daily for days 4-7, 1 mg twice a day for remaining 23 weeks) for increasing
continuous alcohol abstinence rates at 3 and 6 months among patients with alcohol and
tobacco dependence who have completed treatment at the Mayo Clinic IAP.
2. To obtain preliminary evidence of efficacy of varenicline (0.5 mg once daily for 3 days,
0.5 mg twice daily for days 4-7, 1 mg twice a day for remaining 23 weeks) for decreasing
the number of heavy drinking days (> 5 drinks/day for men and > 4 drink/day for women)
at 3 and 6 months among patients with alcohol and tobacco dependence who have completed
treatment at the Mayo Clinic IAP.
3. To obtain preliminary data on baseline and baseline to endpoint change in CSF volume
corrected concentrations of the dorsal striatal glutamate, glutamate + glutamine, and
NAA measures through MR spectroscopy before and after 30 days of varenicline treatment
among patients with alcohol and tobacco dependence who have completed treatment at the
Mayo Clinic IAP.
Secondary aims:
1. To obtain preliminary evidence of efficacy of varenicline (0.5 mg once daily for 3 days,
0.5 mg twice daily for days 4-7, 1 mg twice a day for remaining 23 weeks) for increasing
the 7-day point prevalence smoking abstinence rates and prolonged smoking abstinence at
3 and 6 months among patients with alcohol and tobacco dependence who have completed
treatment at the Mayo Clinic IAP.
2. To assess the tolerability of varenicline (0.5 mg once daily for 3 days, 0.5 mg twice
daily for days 4-7, 1 mg twice a day for remaining 23 weeks).
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