The Effect of Yohimbine on Cocaine Cue Reactivity

NCT ID: NCT00535002

Last Updated: 2017-06-07

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 112 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2007-09-30
• Study Completion Date: 2012-08-31

Brief Summary

Stress and cues reminiscent of cocaine use promote craving and relapse in cocaine dependent individuals. In addition, there appears to be gender differences in determinants of relapse to drug use following abstinence in cocaine-dependent individuals. Therefore the purpose of the present study is to study the role of hormonal status on the response to cocaine-related cues with or without stress in cocaine-dependent women and men.

Detailed Description

Cocaine dependence is an insidious disease underscored by a strong propensity to relapse despite knowledge of the repercussions of continued drug-use. Stress and cocaine cues produce craving and ultimately relapse in cocaine dependent individuals. Pre-clinical research has demonstrated sex differences in response to cocaine-conditioned cues and cocaine-primed reinstatement, which correlates well with reduced plasma progesterone levels. Interestingly, this is consistent with a growing body of clinical literature indicating that progesterone may decrease the reinforcing properties of stimulants in women. Gender differences in the response to a social stressor and cocaine cues in cocaine-dependent individuals have been demonstrated in human laboratory studies, however, the interaction of stress and cues and the effect of hormonal status on response have not been explored. This study examines the role of hormonal status on the response to cocaine-related cues with or without a pharmacological stressor (yohimbine) in cocaine-dependent women and men. As a further integration of the research focus this study also explores the relationship between impulsivity and craving.

Conditions

Cocaine Related Disorders

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Cocaine Females, Yohimbine then Placebo

Cocaine dependent females, received yohimbine day 1 and placebo day 2

Group Type: OTHER

Yohimbine

Intervention Type: DRUG

Participants were pre-treated with either yohimbine or placebo.

Placebo

Intervention Type: DRUG

Cocaine Females, Placebo the Yohimbine

Cocaine dependent females, received placebo day 1 and yohimbine day 2

Group Type: OTHER

Yohimbine

Intervention Type: DRUG

Participants were pre-treated with either yohimbine or placebo.

Placebo

Intervention Type: DRUG

Cocaine Males, Yohimbine then Placebo

Cocaine dependent males, received yohimbine day 1 and placebo day 2

Group Type: OTHER

Yohimbine

Intervention Type: DRUG

Participants were pre-treated with either yohimbine or placebo.

Placebo

Intervention Type: DRUG

Cocaine Males, Placebo thenYohimbine

Cocaine dependent males, received placebo day 1 and yohimbine day 2

Group Type: OTHER

Yohimbine

Intervention Type: DRUG

Participants were pre-treated with either yohimbine or placebo.

Placebo

Intervention Type: DRUG

Control Females, Yohimbine then Placebo

Non-dependent females, received yohimbine day 1 and placebo day 2

Group Type: OTHER

Yohimbine

Intervention Type: DRUG

Participants were pre-treated with either yohimbine or placebo.

Placebo

Intervention Type: DRUG

Control Females, Placebo then Yohimbine

Non-dependent females, received placebo day 1 and yohimbine day 2

Group Type: OTHER

Yohimbine

Intervention Type: DRUG

Participants were pre-treated with either yohimbine or placebo.

Placebo

Intervention Type: DRUG

Control Males, Yohimbine then Placebo

Non-dependent males, received yohimbine day 1 and placebo day 2

Group Type: OTHER

Yohimbine

Intervention Type: DRUG

Participants were pre-treated with either yohimbine or placebo.

Placebo

Intervention Type: DRUG

Control Males, Placebo then Yohimbine

Non-dependent males, received placebo day 1 and yohimbine day 2

Group Type: OTHER

Yohimbine

Intervention Type: DRUG

Participants were pre-treated with either yohimbine or placebo.

Placebo

Intervention Type: DRUG

Interventions

Yohimbine

Participants were pre-treated with either yohimbine or placebo.

Intervention Type: DRUG

Placebo

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Subjects must be able to provide informed consent and function at an intellectual level sufficient to allow accurate completion of all assessment instruments.
• Subjects must consent to remain abstinent from all drugs of abuse (except nicotine) for a three-day period immediately prior to the CTRC admission. Nicotine dependence can affect HPA function (Baron et al., 1995) therefore it would be ideal to exclude subjects with nicotine use. Because of the high comorbidity of cocaine and nicotine dependence, this would seriously compromise the feasibility of recruitment. Individuals with alcohol dependence will be excluded. However because of the high comorbidity of alcohol use and cocaine dependence, individuals with alcohol abuse will be included. Also, due to the high comorbidity of cocaine and marijuana dependence, and limited evidence that marijuana use affects HPA function, subjects with marijuana dependence will be included.
• Subjects with ADHD will be included. Because ADHD is commonly characterized by impulsivity, ADHD severity ratings will be determined and controlled for in data analysis.
• Subjects must consent to random assignment.
• Subjects must consent to outpatient admission to the CTRC and two overnight admissions to the Medical University Hospital.

Exclusion Criteria

• Women who are pregnant, nursing or of childbearing potential and not practicing an effective means of birth control.
• Women with premenstrual dysphoric disorder as this may impact on the response to the stress test procedure (Woods et al., 1994).
• Women receiving depot medroxyprogesterone acetate as a form of birth control.
• Subjects with evidence of or a history of significant hematological, endocrine, cardiovascular, pulmonary, renal, gastrointestinal, or neurological disease including diabetes, as these conditions may affect physiological/subjective responses.
• Subjects with Addison's disease, Cushing's disease or other diseases of the adrenal cortex likely to affect hormonal/neuroendocrine status.
• Subjects with a history of or current psychotic disorder or bipolar affective disorder as these may interfere with subjective measurements.
• Subjects with current major depressive disorder or post-traumatic stress disorder as these disorders are associated with characteristic changes in stress response.
• Subjects with panic disorder, as yohimbine may precipitate panic attacks.
• Subjects receiving synthetic glucocorticoid therapy, any exogenous steroid therapy, or treatment with other agents that interfere with hormonal measurements within one month of test session.
• Subjects taking any psychotropic medications,antidepressants, opiates or opiate antagonists because these may affect test response. Subjects taking SSRI's will be included.
• Subjects with any acute illness or fever. Individuals who otherwise meet study criteria will be rescheduled for evaluation for participation.
• Subjects who are obese (BMI>35) as this may interfere with hormonal status.
• Subjects who are unwilling or unable to maintain abstinence from alcohol and other drugs of abuse (except nicotine) for three days prior to the stress task procedure.
• Subjects meeting DSM-IV criteria for substance dependence (other than nicotine, alcohol, marijuana or cocaine as appropriate) within the past 60 days.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role: collaborator

Office of Research on Women's Health (ORWH)

NIH

Sponsor Role: collaborator

Medical University of South Carolina

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Kathleen T Brady, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Medical University of South Carolina

Locations

Medical University of South Carolina-GCRC

Charleston, South Carolina, United States

Countries

United States

Other Identifiers

P50DA016511

Identifier Type: NIH

Identifier Source: secondary_id

View Link

P50DA016511-1

Identifier Type: -

Identifier Source: org_study_id