Medication and Counseling for Controlled Drinking

NCT01115894 | Unknown Phase 3 DMC

• 1 other identifier: AA015553-01A1S1
• Study Type: interventional
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

Problem drinking gay and bisexual men who try to quit drinking are at risk for relapse to heavy or problematic drinking because their social lives and social outlets are often strongly associated with alcohol. These men are most receptive to interventions focused on moderation of drinking rather than abstinence. However moderation-oriented cognitive-behavior therapy (CBT) and naltrexone (NTX) are both well established treatments for problem drinkers who wish to moderate, rather than stop, drinking. Research suggests that combining these treatments may enhance their efficacy. This study combines moderation-oriented CBT with NTX in the treatment of problem drinking gay and bisexual men, who do not wish to abstain from alcohol, to evaluate their efficacy alone and in combination. We also propose to utilize new data collection technology, Interactive Voice Response, to collect data on daily relations among drinking, sexual behavior and psychological variables thought to mediate treatment response. Our objectives are to evaluation the efficacy of 12 weeks of randomly assigned treatment, with 100 mg of NTX or placebo, combined with brief supportive therapy or modified, behavioral self-control therapy specifically tailored to gay/bisexual men; to evaluate conditional relationships between heavy drinking and likelihood of HIV risk behavior; and to evaluate daily associations among mood, craving, self-efficacy, motivation, and drinking. Assessments will include baseline, 3, 6, \& 9 month follow-up. A substudy of the treatment trial will be conducted to collect and bank samples from blood for research aimed at associating naturally occurring differences in DNA with patient response to NTX, and with potential mediational mechanisms of action of NTX. Information gathered on genes or gene products may be used in conjunction with data on clinical psychological factors obtained as part of the clinical trial to evaluate relationships among genetic variants, drug effects, and mechanisms of treatment response. Patients will be asked to give a blood sample at Week 0 of the clinical trial for the purpose of carrying out genetic research.

Conditions

Alcohol Dependence; Alcohol Abuse

Keywords

problem drinking; alcohol

Outcome Measures

Primary Outcomes (2)

• Quantity of alcohol use

  9 months

• Frequency of binge drinking

  9 months

Secondary Outcomes (1)

• Frequency of HIV risk behavior

  9 months

Study Arms (4)

active medication + psychotherapy

EXPERIMENTAL

Drug: Naltrexone; Behavioral: Modified Behavioral Self-Control Psychotherapy

placebo + psychotherapy

EXPERIMENTAL

Behavioral: Modified Behavioral Self-Control Psychotherapy; Drug: Placebo

active medication+brief supportive counseling

EXPERIMENTAL

Drug: Naltrexone; Behavioral: Brief Behavioral Compliance Enhancement Therapy

placebo + brief supportive counseling

EXPERIMENTAL

Behavioral: Brief Behavioral Compliance Enhancement Therapy; Drug: Placebo

Interventions

Naltrexone DRUG

100 mg oral dosage daily for 12 weeks

active medication + psychotherapy; active medication+brief supportive counseling

Modified Behavioral Self-Control Psychotherapy BEHAVIORAL

Moderation- and cognitive-behaviorally-based psychotherapy. Treatment goal of moderation of alcohol consumption. 12 weekly, 1-hour sessions.

active medication + psychotherapy; placebo + psychotherapy

Brief Behavioral Compliance Enhancement Therapy BEHAVIORAL

Brief supportive counseling to enhance compliance with medication and encourage goal-setting concerning alcohol consumption.

active medication+brief supportive counseling; placebo + brief supportive counseling

Placebo DRUG

Placebo

placebo + brief supportive counseling; placebo + psychotherapy

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Currently sexually active with other men
• Report drinking at levels substantially in excess of established guidelines for non-hazardous drinking
• Willing to reduce drinking to non-hazardous levels
• English literate (8th grade level)

You may not qualify if:

• Current physical disease or condition making participant inappropriate for a medication trial, including total bilirubin elevation \>110% AST or ALT elevations \>300%
• History of serious psychiatric illness (psychotic disorder, bipolar disorder, or psychiatric illness requiring hospitalization)
• Recent (past three month) initiation of psychotropic medication or psychotherapy, or recent change in psychotropic medication treatment
• Current DSM-IV diagnosis of drug (other than nicotine) dependence, or lifetime diagnosis of opioid dependence
• DSM-IV alcohol dependence diagnosis judged clinically severe, history or present evidence of significant alcohol withdrawal symptoms, or recurrent use of alcohol to alleviate withdrawal
• Regular use of opioids in the past month
• History of of hypersensitivity to NTX
• Considered by study physician not to be suitable for receipt of an investigational drug
• Likely to require treatment with opiate pain medication during the course of the study

Sponsors & Collaborators

• Research Foundation for Mental Hygiene, Inc.: lead

Study Sites (1)

Columbia Addiction Services and Psychotherapy Intervention Research

New York, New York, 10019, United States

Location

MeSH Terms

Conditions

Alcoholism

Interventions

Naltrexone

Condition Hierarchy (Ancestors)

Alcohol-Related Disorders; Substance-Related Disorders; Chemically-Induced Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Naloxone; Morphinans; Opiate Alkaloids; Alkaloids; Heterocyclic Compounds; Heterocyclic Compounds, Bridged-Ring; Heterocyclic Compounds, 4 or More Rings; Heterocyclic Compounds, Fused-Ring; Phenanthrenes; Polycyclic Aromatic Hydrocarbons; Polycyclic Compounds

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator

Study Record Dates

• First Submitted: April 30, 2010
• First Posted: May 4, 2010
• Study Start: February 1, 2007
• Primary Completion: December 1, 2010
• Last Updated: December 10, 2012

Record last verified: 2012-12

Locations

US (1)