Cocaine-Related Disorders Clinical Trial
Official title:
Lab Trials to Develop Medication for Cocaine Dependence
Cocaine addiction is a serious health problem with no available medical treatment for preventing relapse. Topiramate, a medication which lowers dopamine levels, may have the ability to diminish cocaine cravings in addicts. The purpose of this study is to determine the effectiveness of topiramate in reducing cocaine's rewarding effects in individuals addicted to cocaine.
GABA is an inhibitory neurotransmitter that is found primarily in the brain. High GABA
levels result in low levels of dopamine, another neurotransmitter that is the brain's "feel
good" chemical and which plays a primary role in cocaine drug addiction. Cravings for
cocaine can be reduced by lowering dopamine levels. This makes topiramate, a GABA-altering
medication, a potential treatment for cocaine addiction. This study will evaluate the
subjective, behavioral, and physiological effects of topiramate in individuals addicted to
cocaine.
Potential participants will initially attend a 4- to 6-hour screening session. This will
include review of medical and drug histories, standardized psychological questionnaires, a
physical exam, and blood collection. Eligible participants will then be admitted to the
inpatient clinic. During the first day of experiment, participants will receive instructions
and information about the study procedures. They will also undergo a physical exam, an
electrocardiogram, standardized psychological questionnaires, and blood and urine
collection. A single test dose of cocaine will be administered intravenously to all
participants to ensure safety with continuation in the study. Vital signs will be monitored
hourly throughout the day.
The experiment will last 25 days and will enroll 24 individuals addicted to cocaine. In this
three-part experiment, participants will be admitted to the inpatient clinic for an 8-day
study session. Following this session, they will be discharged from the clinic for a 1-week
washout phase. Participants will then return to the inpatient clinic for another 8-day study
session. The two study sessions will be identical. During both sessions, participants will
first receive topiramate or placebo for 4 consecutive days. While continuing to receive
topiramate or placebo, participants will then also receive intravenous cocaine or placebo
for 3 consecutive days.Participants will be monitored by the study physician.
Electrocardiograms will be used to monitor heart activity, and blood will be drawn
frequently to monitor levels of cocaine and topiramate. Participants will complete
standardized questionnaires several times each day to assess mood changes and cognitive
function.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Basic Science
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