Alcohol Dependence Clinical Trial
Official title:
Sweet Preference and Alcohol Craving Predict Naltrexone Response in Alcoholism
Purpose: The proposed 2-year investigation will be the first double-blind,
placebo-controlled trial examining the hedonic response to sweet taste (HRST) as a
phenotypic predictor of naltrexone (NTX) response in alcohol dependence. HRST yields two
primary phenotypes—Sweet Likers (SL) and Sweet Dislikers (SDL). Based on preliminary
findings, HRST will be examined in conjunction with craving for alcohol to assess whether
the two factors together provide a more robust predictor of NTX response. The identification
of methods to predict naltrexone response in alcohol dependence is an important goal for
alcohol treatment research. Currently naltrexone is not being used nearly as much as it
should be, in part because clinicians do not believe it is very effective. The development
of tools that would identify which patients are more likely to have a robust response to
naltrexone should lead to increased use of the medication. This could help many patients who
are not now having the opportunity of trying naltrexone.
There are two principal Specific Aims for the study:
Specific Aim 1. To test the hypothesis that a combination of SL/SDL status and initial
alcohol craving will predict % abstinent days (%ABST) during treatment with naltrexone.
Specific Aim 2. To test whether a combination of SL/SDL status and initial alcohol craving
predict % heavy drinking days (%HDD) during treatment with naltrexone.
Participants: There will be 130 alcohol-dependent individuals between 18 and 65 years of age
recruited to participate in this randomized placebo-controlled clinical trial. Eighty
alcohol-dependent individuals will be randomized into the study and we are allowing for 50
screen failures. Participation in this study will be an alternative to standard treatment.
Subjects will be blindly assessed for SL/SDL status to yield 50% representation of each
trait.
Procedures (methods): Subjects who meet general inclusion/exclusion criteria based on the
screening interview will complete a sweet taste assessment. Results, along with craving
score, will be given to the Investigational Drug Services for randomization purposes. The
study is a double-blind, randomized, placebo-controlled clinical trial in which participants
will receive 50 mg oral naltrexone or matching placebo for a 12-week period. In addition
participants will meet with a trained therapist for nine 30-minute BRENDA therapy sessions
Medical monitoring will also be conducted by study physicians and will consist of review of
vital signs, concomitant medication use, and general inquiries into side effects.
;
Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Factorial Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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