NCT00218023

Brief Summary

Cocaine dependence is a major public health problem; an effective primary treatment for cocaine dependent individuals has yet to be found. The purpose of this study is to identify subpopulations and baseline conditions that are most responsive to treatment for cocaine dependent individuals.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
101

participants targeted

Target at P50-P75 for phase_2

Timeline
Completed

Started Mar 2006

Longer than P75 for phase_2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 16, 2005

Completed
6 days until next milestone

First Posted

Study publicly available on registry

September 22, 2005

Completed
5 months until next milestone

Study Start

First participant enrolled

March 1, 2006

Completed
6.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2012

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2012

Completed
5 years until next milestone

Results Posted

Study results publicly available

April 7, 2017

Completed
Last Updated

June 9, 2017

Status Verified

May 1, 2017

Enrollment Period

6.1 years

First QC Date

September 16, 2005

Results QC Date

February 23, 2017

Last Update Submit

May 11, 2017

Conditions

Keywords

cocainecocaine addictioncocaine abuserelapse prevention

Outcome Measures

Primary Outcomes (2)

  • Mean Percentage of Cocaine-positive Urines Over Course of 12 Week Treatment in Subgroup Achieving Abstinence at Baseline

    Cocaine use was determined by assessing for the presence of benzoylecgonine in urine.

    3 times per week (Monday, Wednesday, and Friday) for 12 weeks

  • Mean Percentage of Cocaine-positive Urines Over Course of 12 Week Treatment in Subgroup NOT Achieving Abstinence at Baseline

    Cocaine use was determined by assessing for the presence of benzoylecgonine in urine.

    3 times per week (Monday, Wednesday, and Friday) for 12 weeks

Study Arms (4)

Modafinil plus MI, CM, and CBT

EXPERIMENTAL

The modafinil dose began at 200 mg (day 1) and increased to the fixed dose of 200 mg twice daily (day 2) during the 12 weeks of Phase II. The motivational interviewing (MI) intervention consisted of two 1-h individual therapy sessions on the first and eighth day of Phase I. Contingency management (CM) is a voucher-based intervention. Subjects earned vouchers for cocaine abstinence (during Phase I) and medication compliance (during Phase II). Subjects received weekly, 1-h, individual Cognitive-Behavioral Therapy (CBT) sessions during Phase II.

Drug: ModafinilBehavioral: Motivational Interviewing (MI)Behavioral: Contingency management (CM)Behavioral: Cognitive-Behavioral Therapy (CBT)

Levodopa/Carbidopa plus MI, CM, and CBT

EXPERIMENTAL

Levodopa-carbidopa, in the sustained-release formulation (Sinemet CR), began at a dose of levodopa/carbidopa 400/100 mg (day 1) and increased to the fixed dose of 400/100 mg twice daily (day 2) during the 12 weeks of Phase II. The motivational interviewing (MI) intervention consisted of two 1-h individual therapy sessions on the first and eighth day of Phase I. Contingency management (CM) is a voucher-based intervention. Subjects earned vouchers for cocaine abstinence (during Phase I) and medication compliance (during Phase II). Subjects received weekly, 1-h, individual Cognitive-Behavioral Therapy (CBT) sessions during Phase II.

Drug: Levodopa/CarbidopaBehavioral: Motivational Interviewing (MI)Behavioral: Contingency management (CM)Behavioral: Cognitive-Behavioral Therapy (CBT)

Naltrexone HCl plus MI, CM, and CBT

EXPERIMENTAL

Naltrexone hydrochloride (HCl) doses began at 25 mg (day 1) and increased to the fixed dose of 25 mg twice daily (day 2) during the 12 weeks of Phase II. The motivational interviewing (MI) intervention consisted of two 1-h individual therapy sessions on the first and eighth day of Phase I. Contingency management (CM) is a voucher-based intervention. Subjects earned vouchers for cocaine abstinence (during Phase I) and medication compliance (during Phase II). Subjects received weekly, 1-h, individual Cognitive-Behavioral Therapy (CBT) sessions during Phase II.

Drug: Naltrexone HClBehavioral: Motivational Interviewing (MI)Behavioral: Contingency management (CM)Behavioral: Cognitive-Behavioral Therapy (CBT)

Placebo plus MI, CM, and CBT

PLACEBO COMPARATOR

Placebo capsules were identical in appearance to active drug capsules, and each contained 50 mg riboflavin for subsequent evaluation of medication compliance. The motivational interviewing (MI) intervention consisted of two 1-h individual therapy sessions on the first and eighth day of Phase I. Contingency management (CM) is a voucher-based intervention. Subjects earned vouchers for cocaine abstinence (during Phase I) and medication compliance (during Phase II). Subjects received weekly, 1-h, individual Cognitive-Behavioral Therapy (CBT) sessions during Phase II.

Drug: PlaceboBehavioral: Motivational Interviewing (MI)Behavioral: Contingency management (CM)Behavioral: Cognitive-Behavioral Therapy (CBT)

Interventions

The modafinil dose began at 200 mg (day 1) and increased to the fixed dose of 200 mg twice daily (day 2) during the 12 weeks of Phase I.

Also known as: Provigil
Modafinil plus MI, CM, and CBT

Levodopa-carbidopa, in the sustained-release formulation (Sinemet CR), began at a dose of levodopa/carbidopa 400/100 mg (day 1) and increased to the fixed dose of 400/100 mg twice daily (day 2) during the 12 weeks of Phase I.

Also known as: Simemet CR
Levodopa/Carbidopa plus MI, CM, and CBT

Naltrexone hydrochloride (HCl) doses began at 25 mg (day 1) and increased to the fixed dose of 25 mg twice daily (day 2) during the 12 weeks of Phase I.

Also known as: Naltrexon hydrochloride
Naltrexone HCl plus MI, CM, and CBT

Placebo capsules were identical in appearance to active drug capsules, and each contained 50 mg riboflavin for subsequent evaluation of medication compliance.

Placebo plus MI, CM, and CBT

The primary goal of motivational interviewing (MI) was to assist patients in achieving initial abstinence by increasing motivation and commitment to change. The MI intervention consisted of two 1-h individual therapy sessions on the first and eighth day of Phase I. The client-centered, MI-style sessions focused on building motivation for change, exploring ambivalence, obtaining a commitment to change, making a plan for abstinence (Session 1), providing personalized feedback, reassessing commitment for change, and reevaluating the change plan (Session 2). Masters-level therapists were trained and supervised by the therapy supervisor (ALS), an expert in motivation-based therapies.

Levodopa/Carbidopa plus MI, CM, and CBTModafinil plus MI, CM, and CBTNaltrexone HCl plus MI, CM, and CBTPlacebo plus MI, CM, and CBT

Contingency management (CM) is a voucher-based intervention. Subjects earned vouchers for cocaine abstinence (during phase I) and medication compliance (during phase II).

Levodopa/Carbidopa plus MI, CM, and CBTModafinil plus MI, CM, and CBTNaltrexone HCl plus MI, CM, and CBTPlacebo plus MI, CM, and CBT

Subjects received weekly, 1-h, individual Cognitive-Behavioral Therapy (CBT) sessions during Phase II. This therapy component focused on coping-skills training for resisting cocaine use in high-risk situations, based on relapse-prevention theory and manual-guided techniques. Therapy sessions were conducted by master's-level licensed professional counselors supervised by a licensed clinical psychologist, who monitored manual adherence and competency.

Levodopa/Carbidopa plus MI, CM, and CBTModafinil plus MI, CM, and CBTNaltrexone HCl plus MI, CM, and CBTPlacebo plus MI, CM, and CBT

Eligibility Criteria

Age18 Years - 55 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Meets DSM-IV criteria for current cocaine dependence

You may not qualify if:

  • Meet diagnostic criteria for other serious psychiatric symptoms and/or disorders that would interfere with participation in the treatment study (e.g., psychosis; mania; suicidal/ homicidal ideation) including other forms of drug dependence, nicotine and cannabis excepted.
  • Medical conditions contraindicating naltrexone therapy (e.g., past history of opioid use in the 30 days prior to study entry or significant hepatocellular injury)
  • Medical conditions contraindicating modafinil therapy (e.g., hypertension, seizures, arrhythmia, or coronary artery disease)
  • Medical conditions contraindicating levodopa/carbidopa therapy (e.g., severe pulmonary/cardiovascular disease, narrow angle glaucoma, melanoma, history of peptic ulcer, or renal function impairment)
  • Requires certain medications
  • Current or recent treatment for substance use or other psychiatric condition
  • On parole or probation that requires reports of drug use to officers of the court
  • Pending incarceration
  • Pregnant or breastfeeding
  • Unable to read, write, or speak English
  • Plans to leave the study area within 3 months of study entry

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The University of Texas Health Science Center at Houston

Houston, Texas, 77030, United States

Location

Related Publications (1)

  • Schmitz JM, Green CE, Stotts AL, Lindsay JA, Rathnayaka NS, Grabowski J, Moeller FG. A two-phased screening paradigm for evaluating candidate medications for cocaine cessation or relapse prevention: modafinil, levodopa-carbidopa, naltrexone. Drug Alcohol Depend. 2014 Mar 1;136:100-7. doi: 10.1016/j.drugalcdep.2013.12.015. Epub 2014 Jan 3.

MeSH Terms

Conditions

Cocaine-Related Disorders

Interventions

Modafinilcarbidopa, levodopa drug combinationNaltrexoneMotivational InterviewingCognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Substance-Related DisordersChemically-Induced DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Benzhydryl CompoundsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsNaloxoneMorphinansOpiate AlkaloidsAlkaloidsHeterocyclic CompoundsHeterocyclic Compounds, Bridged-RingHeterocyclic Compounds, 4 or More RingsHeterocyclic Compounds, Fused-RingPhenanthrenesPolycyclic Aromatic HydrocarbonsPolycyclic CompoundsDirective CounselingCounselingMental Health ServicesBehavioral Disciplines and ActivitiesHealth ServicesHealth Care Facilities Workforce and ServicesBehavior TherapyPsychotherapy

Limitations and Caveats

The sample size was small; however, the main aim of the study was achieved (i.e., to evaluate the feasibility of using a two-phase abstinence induction paradigm to screen candidate medications for cocaine treatment).

Results Point of Contact

Title
Joy M. Schmitz, PhD
Organization
The University of Texas Health Science Center at Houston

Study Officials

  • Joy M Schmitz, PhD

    University of Texas

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor - Psy, Behavioral Science

Study Record Dates

First Submitted

September 16, 2005

First Posted

September 22, 2005

Study Start

March 1, 2006

Primary Completion

April 1, 2012

Study Completion

April 1, 2012

Last Updated

June 9, 2017

Results First Posted

April 7, 2017

Record last verified: 2017-05

Locations