Investigation of Mifepristone (RU486) on Stress Sensitivity and Relapse Prevention in Cocaine Dependent Patients

NCT ID: NCT01134198

Last Updated: 2018-12-20

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2018-02-14

Brief Summary

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This research will evaluate the impact of blocking central and peripheral glucocorticoid receptors on stress sensitivity and the risk of relapse to cocaine use in treatment-seeking cocaine-dependent individuals. Mifepristone (RU-486) will be the glucocorticoid antagonist used.

Detailed Description

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This study attempts to reduce relapse risk by blocking glucocorticoid receptors, and thus allow some of the changes in the brain caused by cocaine to redress themselves

Conditions

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Cocaine Dependence

Keywords

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Cocaine Dependence

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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Mifepristone

Mifepristone 600mg

Group Type ACTIVE_COMPARATOR

Mifepristone

Intervention Type DRUG

Mifepristone 600mg, 3x/wk for 4 weeks

placebo

Placebo

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

placebo

Interventions

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Mifepristone

Mifepristone 600mg, 3x/wk for 4 weeks

Intervention Type DRUG

placebo

placebo

Intervention Type DRUG

Other Intervention Names

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RU486

Eligibility Criteria

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Inclusion Criteria

1. Age 18 to 60.
2. Male.
3. Meets DSM?IV criteria for current cocaine dependence and is seeking treatment.
4. Identifies life stress (work, interpersonal, financial, etc) as a trigger for cocaine use or reports uncontrollable craving to use of cocaine.
5. Displays at least one cocaine-positive urine toxicology during screening.
6. Uses cocaine at least 4/30 days in the past month, or reports episodic binges of large amounts of cocaine (at least $200) at least 2x/month.
7. Able to give informed consent and comply with study procedures.

Exclusion Criteria

1. Meets DSM-IV criteria for major depression, bipolar disorder, schizophrenia or any psychotic disorder other than transient psychosis due to drug abuse. Substance Induced Mood Disorder with Hamilton Depression Scale score ³13 will be excluded.
2. History of seizures in the last 2 years, or history of seizures related to the substance (cocaine, alcohol, or benzodiazepine) that the patient continues to use.
3. History of allergic, dermatological, or adverse event to mifepristone
4. Chronic organic mental disorder, insufficient proficiency in English that would render an individual incapable of giving informed consent.
5. Significant current suicidal risks, history of significant suicidal behavior or any suicide attempt within the past year.
6. Unstable physical disorders, which might make participation hazardous such as hypertension (\>140/90), WBC \< 3.5, new diagnosis of hepatitis (patients with chronic mildly elevated transaminase levels (£2-3 X upper limit of normal will be considered acceptable if PT/PTT is normal), renal failure (creat \> 2; BUN \> 40), or diabetes (HbA1c \> 7%), and low Hb (\< 12g/dL) or low Hct (\<36%).
7. Coronary vascular disease as indicated by history, or suspected by abnormal ECG or history of cardiac symptoms. Hx of cardiac symptoms (chest pain, chest pressure, shortness of breath, syncope) during cocaine use.
8. Cardiac conduction system disease as indicated by QRS duration of ³ 0.11 msec.
9. Currently meets DSM-IV criteria for another substance dependence or abuse disorder other than nicotine, alcohol, or cannabis. If alcohol dependent, must not be in need of detoxification. Heavy male drinkers (who consume greater than 5 standard alcoholic drink per day per NIAAA definition) will be excluded.
10. Presents with metabolic indicators of hypoadrenalism such as low serum sodium (\<130 mEq/L), high serum potassium (\>5.5 mEq/L), Na/K ratio \< 30:1, low fasting blood sugar (\<50 mg/dL), or high BUN (\>20 mg/dL), or a previous history of Addison's disease or adrenal insufficiency, or the presence of low K (\< 3.5 mEq/L). spot AM cortisol \<5ug/dL, PM cortisol \< 3 ug/dL
11. Participants who cannot comply with study procedures during the initial hospitalization phase.

13: Patients taking medications metabolized by cytochrome 3A4 (ex: erythromycin, protease inhibitors) or that inhibit this cytochrome; or consuming grapefruit juice.

14: Patients with an underlying hemorrhagic disorder and those on anti-coagulants. INR \> 1.1, PT \> 17 msecs, total plt \<100x109/L.

15: Use of treatment agents that inhibit steroid biosynthesis by the adrenal cortex, such as metyrapone, ketoconazole, fluconazole, aminoglutethimide, or etomidate. Patients also requiring inhaled steroids.

16\. Female
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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New York State Psychiatric Institute

OTHER

Sponsor Role lead

Responsible Party

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Wilfrid Raby

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Wilfid N Raby, Md, PhD

Role: PRINCIPAL_INVESTIGATOR

NYSPI

Locations

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STARS

New York, New York, United States

Site Status

Countries

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United States

Other Identifiers

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RU486 for Cocaine Dependence

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

6013

Identifier Type: -

Identifier Source: org_study_id