Depression Clinical Trial
Official title:
A Placebo Controlled Trial of Mirtazapine for Patients With Depression and Cocaine Dependence
Many substance dependent individuals also suffer from depression. Past research suggests that antidepressant medication is helpful in treating such individuals. This study will determine the effectiveness of mirtazapine, an antidepressant medication, in treating cocaine dependent individuals who also suffer from depression. This study includes free treatment for cocaine dependence that includes medication and a behavioral intervention.
Cocaine abuse and depression often occur together. Individuals suffering from both are
usually not able to quit abusing cocaine. Past research conducted on alcohol dependent
individuals also suffering from depression showed that these individuals were able to
successfully quit drinking with the addition of an antidepressant medication. Mirtazapine is
a medication currently used to treat depression. This study will evaluate the efficacy of
mirtazapine, used in combination with behavioral therapy, in treating cocaine dependent
individuals who also suffer from depression.
Participants in this 8-week trial will be randomly assigned to receive either mirtazapine or
placebo. Prior to starting medication treatment, participants will undergo an initial 2-week
phase consisting of psychosocial and behavioral therapy. The purpose of this lead-in phase is
to achieve initial reduction or abstinence in cocaine use, while observing cocaine withdrawal
symptoms and mood changes associated with depression. During these first 2 weeks,
participants will attend three study visits each week, at which time they will participate in
motivational interviews and cognitive behavioral relapse prevention therapy. During this
phase, participants who successfully remain abstinent from cocaine use will be rewarded with
high-value monetary vouchers.
Upon completing the lead-in phase, participants will be randomly assigned to receive either
mirtazapine or placebo. Participants will attend study visits twice each week for 8 weeks.
Mood and drug use will be evaluated at each study visit. Cognitive behavioral relapse
prevention therapy will continue throughout the study. In addition, participants will earn
low-value monetary vouchers contingent on cocaine abstinence.
At the end of Week 8, participants will enter the lead-out phase. At this time, those
participants whose mood has significantly improved will be able to continue treatment for an
additional 8 weeks. Participants whose mood has not shown improvement will be tapered off
their assigned medication treatment and will be offered treatment with an alternative
medication. Following completion of the lead-out phase, all participants will be referred for
continuing care in the community.
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