Substance-Related Disorders Clinical Trial
Official title:
Early Phase II Trials for Cocaine Medication Development
The purpose of this study is to develop models for early Phase II testing of potential
medications for cocaine dependence: amoxapine, risperidone and other agents.
The study was a controlled pilot trial of risperidone in opiate-dependent patients on
methadone maintenance. The study explored whether risperidone reduced cocaine use, cocaine
craving, and cocaine subjective effects in patients on methadone maintenance who abused
cocaine and whether it had an acceptable side effect profile. This
This was an 18-week prospective, randomized, placebo-controlled crossover design with
placebo lead-in phase and terminal placebo phase. After two weeks of single-blind placebo,
patients were randomly assigned to one of two schedules of medication:
2 Week Baseline Weeks 1-6 Weeks 7-12 Weeks 13-18 Group 1 placebo risperidone placebo placebo
Group 2 placebo placebo risperidone placebo
The first 6-week phase provided an initial double-blind medication-placebo comparison. In
the second six-week phase (weeks 7-12), patients crossed over to the opposite treatment.
During weeks 13-18, Group 1 patients remained on placebo while Group 2 patients were tapered
from risperidone to placebo. For six weeks after the end of the trial, patients were offered
routine clinical treatment with counseling and psychiatrist visits as needed. Medication
dosage was titrated upwards on a fixed-flexible schedule to a maximum dose of 4 mg per day.
Medication began at ½ mg risperidone for 3 days, then 1 mg for four days, 2 mg per day
during week 2, 3 mg per day during week 3, and 4 mg per day during weeks 4-6. The titration
schedule for risperidone in weeks 7-12 was the same as for weeks 1-6. In addition to
treatment as usual, patients received a modified manual-guided relapse prevention counseling
program in weekly meetings lasting approximately 20 minutes; these sessions provided
cognitive and behavioral skills that were found to be helpful to patients in reducing
cocaine use.
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