Mirtazapine for Treating Cocaine Dependent Individuals Who Also Suffer From Depression

NCT ID: NCT00249444

Last Updated: 2017-10-25

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

86 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-05-31

Study Completion Date

2012-12-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Cocaine Dependence Depression

Keywords

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cocaine dependence mirtazipine

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Mirtazapine

Mirtazapine will be administered on a fixed-flexible schedule, with dose titrated up to 60 mg per day or the maximum tolerated dose.

Group Type ACTIVE_COMPARATOR

Mirtazapine

Intervention Type DRUG

Mirtazapine

Placebo

placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

placebo

Interventions

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Mirtazapine

Mirtazapine

Intervention Type DRUG

Placebo

placebo

Intervention Type DRUG

Other Intervention Names

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Remeron

Eligibility Criteria

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Inclusion Criteria

* Meets DSM-IV criteria for current cocaine dependence
* Currently seeking treatment for cocaine dependence
* Used cocaine for at least one day per 2-week period in the month prior to study entry
* Meets DSM-IV criteria for current major depression or dysthymia syndrome
* Scores greater than 12 on the Baseline 21 Hamilton Depression Scale
* Ages 18-60

Exclusion Criteria

* Meets DSM-IV criteria for past mania (e.g., bipolar disorder), schizophrenia, or any psychotic disorder other than transient psychosis due to drug abuse
* Scores less than 11 on the Baseline 21 Hamilton Depression Scale
* History of seizures
* History of an allergic reaction to mirtazapine
* Chronic organic mental disorder
* Current suicidal risks or any history of suicidal behavior
* Pregnant, breastfeeding, or unwilling to use an adequate method of contraception for the duration of the study
* Unstable physical disorders, including high blood pressure, acute hepatitis, or diabetes
* Coronary vascular disease as indicated by history, or suspected by abnormal electrocardiogram, or history of cardiac symptoms
* Cardiac conduction system disease, as indicated by an electrocardiogram QRS duration greater than 0.11
* History of failure to respond to a previous trial of mirtazapine
* Currently taking psychotropic medication
* Meets DSM-IV criteria for opioid or sedative-hypnotic dependence
* Meets DSM-IV criteria for alcohol dependence with evidence of clinically significant physiological dependence in need of medically supervised detoxification
* Current alcohol or marijuana dependence identified as the main problem for seeking treatment; individuals with alcohol or marijuana dependence (without significant physiological dependence) and cocaine dependence are eligible, as long as cocaine is identified as the primary substance problem for which they are seeking treatment
* History of neutropenia (\< 500 granulocytes /cc) or Agranulocytosis (\<500 granulocytes/cc) with fever, infection. Concurrent intake of medications with possible neutropenic effects: chlorpromazine, carbamazepine, clozapine, chemotherapeutic drugs, immunosuppressant medications, interferons, ganciclovir, protease inhibitors.
* Patients not able to meet attendance requirement of 4/6 visits during the lead-in period.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

New York State Psychiatric Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Wilfrid Raby, MD

Role: PRINCIPAL_INVESTIGATOR

New York State Psychiatric Institute

Locations

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Research Foundation for Mental Hygiene, Inc.

New York, New York, United States

Site Status

Countries

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United States

Related Links

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Other Identifiers

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P50DA009236

Identifier Type: NIH

Identifier Source: secondary_id

View Link

P50DA009236-13

Identifier Type: NIH

Identifier Source: secondary_id

View Link

DPMC

Identifier Type: OTHER

Identifier Source: secondary_id

5086/6177R NIDA-09236-13

Identifier Type: -

Identifier Source: org_study_id