Does the Threat of an Aversive Reaction Affect Craving of Alcohol During Cue Exposure in Alcohol Dependent Patients?

Alcoholic Intoxication, Chronic Clinical Trial

Official title:

Does the Threat of an Aversive Reaction Affect Craving of Alcohol During Cue Exposure in Alcohol Dependent Patients?

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00372749
• Other study ID #: P051058
• Status: Completed
• Phase: N/A
• First received: September 5, 2006
• Last updated: March 25, 2011
• Start date: October 2006
• Est. completion date: March 2009

Study information

• Verified date: February 2007
• Source: Assistance Publique - Hôpitaux de Paris
• Contact: n/a
• Is FDA regulated: No
• Health authority: France: Ministry of Health
• Study type: Interventional

Clinical Trial Summary

To evaluate the effect of the threat of an aversive reaction on the response during alcohol cue exposure in alcohol dependent patients : (1) the subjective response (craving) and (2) the physiological response (heart rate and blood pressure).

Description:

The efficacy of disulfiram in relapse prevention is controversial. Not only are most of the studies dated but their methodological rigor is generally poor. The major obstacle to disulfiram's effectiveness is non-compliance. No study to date has directly explored whether the threat of a disulfiram ethanol reaction (DER), provoked by the ingestion of disulfiram, has an effect on craving. Alcohol dependent patients have difficulty tolerating craving, a phenomenon that is believed to increase the probability of relapse. We propose in this study an evaluation of alcohol craving in relation to the threat of a DER compared to no threat. In both of these experimental conditions, we will use a placebo in order to avoid confounding the pharmacological effect of disulfiram with the psychological effect of the threat. Craving will be evaluated in the context of the multidimensional model of ambivalence (BREINER, STRITZKE and Lang, 1999) which provides two independent dimensions, craving and aversion.

To evaluate the effect of the threat of an aversive reaction on the response during alcohol cue exposure in alcohol dependent patients : (1) the subjective response (craving) and (2) the physiological response (heart rate and blood pressure).

• To evaluate the correlation between the subjective and physiological responses to alcohol cue exposure in relation to the threat of an aversive reaction.

• To evaluate the moderating effects of mood and personality on alcohol cue exposure in relation to the threat of an aversive reaction.

The design of this study is a within-subject, single-blind, randomized, and monocentric. The participants will be exposed to their habitual alcoholic drink. They will receive a placebo with two types of randomized inductions : (1) the threat of an aversive reaction and (2) no threat. The initial inclusion visit will take place a minimum of six days after the patients consumed their last alcohol beverage, the first cue exposure will take place one to seven days after the inclusion visit, and the second cue exposure will take place four to eight days after the first. This study directly benefits the patient because the experience of cue exposure provokes habituation.

The demonstration of an effect of the threat of an aversive reaction on craving may help alcohol dependent patients to better accept treatment using disulfiram as they would view it as alleviating craving instead of strictly as a punitive measure in the event of alcohol intake.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 30
• Est. completion date: March 2009
• Est. primary completion date: March 2009
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Inpatients

• Alcohol dependence

• Detoxified since at least one week

• Willing to abstain from alcohol for at least 6 months

• Never treated with disulfiram

Exclusion Criteria:

• Any contra-indication to disulfiram

• Treated with and antidepressant or a neuroleptic medication within the 30 previous days

• Treated with acamprosate, naltrexone, betablockers or clonidine within the 7 previous days

• Treated with benzodiazepines within the 3 previous days (except diazepam, maximum 30 mg/d)

• Anosmia

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Alcoholic Intoxication
• Alcoholic Intoxication, Chronic
• Alcoholism

Intervention

Behavioral:
• Aversive reaction during alcohol cue exposure
Aversive reaction during alcohol cue exposure

Locations

Country	Name	City	State
France	Hopital Emile Roux APHP	Limeil-Brevannes

Sponsors (2)

Lead Sponsor	Collaborator
Assistance Publique - Hôpitaux de Paris	Institut de Recherches Scientifiques sur les Boissons

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Alcohol craving visual analogic evaluation	Alcohol craving visual analogic evaluation	during de study	Yes
Secondary	Blood Pressure and Pulse Rate	Blood Pressure and Pulse Rate	during the study	Yes