Alcoholism Clinical Trial
Official title:
Targeted Naltrexone for Problem Drinkers
The purpose of this study is to determine whether naltrexone, combined with brief coping skills therapy, is effective in the treatment of heavy drinking.
This is a 12-week, placebo-controlled trial of naltrexone (50 mg orally) in 163 problem
drinkers. Problem drinkers are those individuals whose drinking puts them at risk of a
variety of psychosocial and medical problems, including alcohol dependence, but who are not
physically dependent on alcohol. They are estimated to comprise up to 20% of the general
population. The study employed a factorial design in which the effects of medication
(naltrexone vs. placebo), schedule of medication administration (i.e., daily vs. targeted),
and the interaction of these factors on drinking behavior were examined. Targeted
administration refers to the use of medication to cope with anticipated high-risk drinking
situations.
The daily monitoring using interactive voice response technology of mood, desire to drink,
perceived self-efficacy, and drinking behavior will make it possible to examine in depth the
processes by which the study variables exert their effects. Daily monitoring was performed
using automated telephone interviews, with in-person follow-up evaluations conducted at 3
and 6 months post-treatment to provide a measure of the durability of treatment effects.
A pharmacogenetic analysis based on preliminary evidence showing that a functional
polymorphism in the gene encoding the mu-opioid receptor (OPRM1) affects response to
naltrexone will serve to explore an important source of variation in the response to
naltrexone treatment. Exploratory analyses involving other potential genetic moderators of
the response to naltrexone, such as the gene encoding the delta opioid receptor (OPRD1),
will also be conducted, as will the correlation of genotype data with other phenotypes.
Careful evaluation of the study hypotheses will provide important information on the
efficacy and mechanism of the effects of targeted naltrexone in problem drinkers. This study
will allow us to model effects across multiple levels of analysis in an effort to understand
the psychopharmacological mechanisms underlying the therapeutic effects of naltrexone in
problem drinkers and to apply novel genetic findings to understanding the pharmacogenetic
mechanisms underlying the therapeutic effects of naltrexone in problem drinkers.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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