Cocaine Dependence Clinical Trial
Official title:
Modafinil, Sleep, and Cognition in Cocaine Dependence
Subjects participating in this protocol will participate in three phases: 1) pre-admission, 2) inpatient admission, and 3) follow-up. Pre-admission involves screening (detailed in inclusion/exclusion criteria section) and one week of outpatient sleep and activity monitoring. Inpatient admission is 16 consecutive nights on the Clinical Neuroscience Research Unit and involves subjective and objective tests of sleep, sleepiness, attention, and learning. During inpatient admission subjects will take modafinil or placebo. For follow-up, subjects will return to the CNRU for one night and again participate in objective tests of sleep, sleepiness, attention, and learning. We hypothesize that modafinil will decrease subject and objective measures of sleepiness and will promote attention and learning in cocaine dependent persons.
A relatively new treatment for the excessive daytime sleepiness (EDS) associated with
inadequate sleep is the drug modafinil. Modafinil decreases subjective reports and objective
measures of daytime sleepiness under conditions of sleep restriction, while enhancing
cognitive performance. At the same time, sleep quality does not appear to be affected
significantly. Interestingly, recent clinical trials in cocaine-dependent populations
suggest that modafinil reduces the relapse to cocaine use, by unknown mechanisms.
We propose to employ both subjective and objective measures of nocturnal sleep and daytime
sleepiness, as well as measures of general cognitive performance and sleep-dependent memory
consolidation, to explore potential mechanistic relationships between cocaine abstinence,
EDS, and modafinil's efficacy in preventing cocaine relapse.
The following specific aims are proposed:
Specific Aim 1: To establish whether objective measures of poor nocturnal sleep (e.g.,
reduced total sleep time and sleep efficiency) that progressively characterize periods of
sustained cocaine abstinence are also associated with objective evidence of excessive
daytime sleepiness (EDS).
Specific Aim 2: To establish the ability of modafinil to reverse the excessive daytime
sleepiness (EDS) and deficits in cognitive performance that characterize cocaine abstinence.
Specific Aim 3: To conduct a pilot study to determine whether the observed abnormalities in
objective sleep, EDS, and/or cognitive function predict relapse to cocaine use and/or
whether successful abstinence from cocaine is associated with normalization of the same.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor)
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