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The Use of Anticonvulsants for Treatment of Patients With Alcohol Dependence and Post Traumatic Stress Disorder

NCT ID: NCT00571246

Last Updated: 2020-11-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE3

Study Classification

INTERVENTIONAL

Study Start Date

2012-06-30

Study Completion Date

2016-06-30

Brief Summary

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The objective of this study is to evaluate the efficacy of topiramate (250mg) or lamotrigine (250mg) versus placebo in reducing alcohol consumption and decreasing symptoms of PTSD in patients with comorbid AD and PTSD.

Detailed Description

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There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with PTSD. Despite this, little is known about how to best treat individuals with comorbid AD and PTSD. The use of anticonvulsants represents a novel approach to treatment that may target symptoms of both AD and PTSD. Both Topiramate and Lamotrigine act on the GABAergic and glutamatergic systems. Topiramate has GABAergic effects by robustly increasing brain GABA, and antiglutamatergic effects by inhibiting glutamate function that might antagonize alcohol's rewarding effects in AD and could contribute to the regulating of reexperiencing and arousal symptoms in PTSD. Lamotrigine is a glutamate-inhibiting anticonvulsant that has shown efficacy in some dually diagnosed patients with alcohol dependence, and in patients with PTSD. Neither topiramate nor lamotrigine have been used to treat patients with comorbid PTSD and AD. Methods: Ninety men and women with a current diagnosis of AD and PTSD will be enrolled in a 16-week trial. They will be assigned, in a double-blind fashion, to either topiramate, lamotrigine or placebo. Significance: This project will be the first to compare anticonvulsants (topiramate and lamotrigine) to placebo as effective treatments for reducing alcohol consumption and PTSD symptoms in patients with AD and PTSD.

Conditions

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Alcohol Dependence Post Traumatic Stress Disorder

Keywords

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treatment Lamotrigine Topiramate alcohol dependence post traumatic stress disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Topiramate

Participants will be randomized to topiramate (250mg)

Group Type EXPERIMENTAL

Topiramate

Intervention Type DRUG

Participants are randomized to take Topiramate (250mg/day) 2 times a day

Lamotrigine

Participants will be randomized to lamotrigine (250mg)

Group Type EXPERIMENTAL

lamotrigine

Intervention Type DRUG

Participants are randomized to take Lamotrigine (250 mg/day) 2 times a day

Placebo

Participants will be randomized placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Participants are randomized to take placebo

Interventions

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Topiramate

Participants are randomized to take Topiramate (250mg/day) 2 times a day

Intervention Type DRUG

lamotrigine

Participants are randomized to take Lamotrigine (250 mg/day) 2 times a day

Intervention Type DRUG

Placebo

Participants are randomized to take placebo

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Males and females between the ages of 18-60 years old.
2. Current alcohol abuse or dependence
3. Current PTSD
4. Patients with current alcohol dependence, with at least one recent episode of heavy drinking (defined as 5 or more drinks per drinking episode) over the past 14 days, and during a consecutive 30-day period within the 90 days prior to baseline evaluation.
5. Individuals who are on a stable dose (no less than 2 weeks) of antidepressant medication.
6. Medically and neurologically healthy on the basis of history, physical examination, EKG, screening laboratories (CBC w/ differential, TSH, Free-T4, ASAT, ALAT, GGT, BUN, creatinine, calcium, phosphorous, magnesium, total protein, albumin, electrolytes, VDRL, urinalysis, beta-HCG)
7. For women, negative pregnancy test and use of acceptable method of contraception.

Exclusion Criteria

1. Females who are pregnant or lactating.
2. Individuals with a current unstable medical condition such as neurological, cardiovascular, endocrine, renal, liver, or thyroid pathology (LFT \> 3 times normal, abnormal BUN and creatinine, and unmanaged hypertension with BP \> 200/120) which in the opinion of the physician would preclude the patient from fully cooperating or be of potential harm during the course of the study (includes those with a history of glaucoma, prostatic hypertrophy, urethral obstruction, cerebral arteriosclerosis, pyloric stenosis).
3. Patients who meet current SCID criteria for a major Axis I diagnosis (Bipolar Disorders, Schizophrenia and Schizophrenia-type Disorders).
4. History of substance dependence (other than alcohol, tobacco or cannabis) by DSM-IV criteria in the last 90 days.
5. Individuals taking mood stabilizers and antipsychotic medications.
6. Individuals with a history of allergies to topiramate or lamotrigine.
Minimum Eligible Age

21 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yale University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ismene L Petrakis, MD

Role: PRINCIPAL_INVESTIGATOR

VA Connecticut Healthcare System

Locations

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VA Connecticut Healthcare System

West Haven, Connecticut, United States

Site Status

Countries

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United States

Other Identifiers

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0705002634

Identifier Type: -

Identifier Source: org_study_id