Tobacco Dependence Clinical Trial
Official title:
Pharmacogenetic Investigation of Naltrexone
Despite preclinical evidence supporting the role of the endogenous opioid system in the
reinforcing effects of nicotine, the efficacy of the opioid antagonist naltrexone (NTX) as a
tobacco dependence treatment remains unresolved. Research is needed to identify those
smokers for whom NTX will have the strongest beneficial effects on smoking behavior.
The research bridges existing knowledge of genetic, pharmacologic, and behavioral responses
to nicotine, and translates this knowledge to treatment for tobacco dependence. The
immediate goal was to test whether genetic variation in the mu-opioid receptor gene predicts
the effects of naltrexone (NTX) on nicotine reinforcement.
The study was a within-subject double-blind study of the effects of naltrexone versus
placebo on the reinforcing value of nicotine, using a validated cigarette choice paradigm. A
key question was whether smokers differ in their responses based on the mu opioid receptor
gene (OPRM1) Asn40Asp (A118G) variant.
Following informed consent, 64 smokers were enrolled in the study. Of these, 60 completed
two 4-day study phases interspersed with a 5-7 day washout phase. Baseline statistics are
provided for the 64 smokers who enrolled.
Each 4-day study phase included a 3-day drug run-up and monitoring phase, then on the 4th
day participants came to our Biobehavioral Lab (BBL) where they took their final 50mg of
study medication and completed a cigarette choice paradigm. Following a washout phase, the
4-day sequence will be repeated with the alternative study medication. The order of study
medication was randomized and counterbalanced between subjects.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator)
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