Medications Development for the Treatment of Cannabis Related Disorders

NCT ID: NCT01204723

Last Updated: 2012-06-01

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1
• Total Enrollment: 63 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2009-08-31
• Study Completion Date: 2012-04-30

Brief Summary

The primary objective of this application is to test the neurobehavioral mechanisms and effects of aprepitant as a new cessation agent for cannabis, tobacco or both.

Detailed Description

Stress (emotional, physical, social) facilitates drug seeking behavior through the activation of the HPA axis, autonomic nervous system, and brain DA systems. Furthermore, alterations within several neuropeptide systems (CRF, Substance P, and others) also contribute to the role of stress in addiction. Central to this project is that anxiety and stress responses are modulated by substance P and its preferred target, the NK1 receptor. Therefore the aim of this pilot clinical trial is to determine the safety and efficacy of aprepitant (a neurokinin 1 (NK1) receptor antagonist). We hypothesize that the NK1 receptor antagonist, aprepitant, will be safe, tolerable and efficacious at reducing the withdrawal symptoms, cue craving, and reinforcement value for both cannabis and tobacco resulting from the cessation of either or both drugs. We will assess this hypothesis in the context of a carefully controlled human laboratory study in which subjects (N=72) will be randomized in a 3 x 2 factorial design to one of 3 behavioral conditions; a) withdrawn from both substances, b) withdrawn from tobacco only, or c) withdrawn from cannabis only, and to receive one of 2 medication dose conditions: placebo or aprepitant (160 mg/day). Medication will be administered for 5 days, followed by a cue challenge, choice procedure, and then a consequence (i.e., oral cannabis or a cigarette or money) also on day 5.

Conditions

Nicotine Withdrawal; Marijuana Dependence; Cannabis Dependence; Nicotine Dependence; Cannabis Abuse

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: BASIC_SCIENCE
• Blinding Strategy: QUADRUPLE

Study Groups

Behavioral Condition 1

Nicotine patch (21 mg) plus placebo oral cannabis (0 mg; 3 times a day on days 2-4, given once on day 5)

Group Type: EXPERIMENTAL

Placebo Aprepitant

Intervention Type: DRUG

Placebo Aprepitant 0 mg once daily for 5 days

Active Aprepitant

Intervention Type: DRUG

Active Aprepitant 160 mg once daily for 5 days

Behavioral Condition 2

Placebo nicotine patch (0 mg) plus oral cannabis (10 mg, 3 times each day, days 2-4, day 5 given once)

Group Type: EXPERIMENTAL

Placebo Aprepitant

Intervention Type: DRUG

Placebo Aprepitant 0 mg once daily for 5 days

Active Aprepitant

Intervention Type: DRUG

Active Aprepitant 160 mg once daily for 5 days

Behavioral Condition 3

Placebo nicotine patch (0 mg) plus placebo oral cannabis (0 mg, 3 times each day days 2-4, day 5 given once)

Group Type: EXPERIMENTAL

Placebo Aprepitant

Intervention Type: DRUG

Placebo Aprepitant 0 mg once daily for 5 days

Active Aprepitant

Intervention Type: DRUG

Active Aprepitant 160 mg once daily for 5 days

Interventions

Placebo Aprepitant

Placebo Aprepitant 0 mg once daily for 5 days

Intervention Type: DRUG

Active Aprepitant

Active Aprepitant 160 mg once daily for 5 days

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Must meet DSM-IV/ICD-10 criteria for cannabis abuse or dependence
• Must be non-treatment seeking individuals
• Participant does not meet DSM-IV criteria for any current (i.e., criteria met at any point in the past 30 days) dependence on a substance other than alcohol, nicotine, caffeine, or marijuana or physiological dependence on alcohol requiring medical detoxification.
• No subjects who have trouble reading the English language or visual or hearing problems that may interfere with the collection of data
• Not currently taking other medications (with the exception of oral contraceptives) that would preclude safe participation in this study
• Must test negative for pregnancy prior to inclusion
• females using birth control pills must agree to use a condom during intercourse for 1 month after participation in study because the study medication will decrease the effectiveness of the birth control pill rendering it ineffective
• Should be in general good health
• No evidence of recent use of other illicit drugs on a urine toxicity screen prior to admission

Exclusion Criteria

• Major current (within last 90 days) Axis I psychopathology (e.g., major depressive disorder, bipolar disorder, schizophrenia)
• Presence of significant medical illness (e.g., diabetes, cardiovascular disease, hypertension, cancer, epilepsy, kidney disease)
• Current, repeated illicit drug use (other than marijuana)
• Subject is breastfeeding or pregnant
• Concurrent therapy with drugs known to inhibit CYP3A4 activity
• Request for drug treatment
• Current parole or probation
• Recent history of significant violent or suicide behavior
• Allergic to sesame oil

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role: collaborator

University of Virginia

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Heather M Haughey, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Virginia School of Medicine, Dept. Psychiatry and Neurobehavioral Sciences

Locations

Clinical Pharmacological Research Unit (CPRU), University of Virginia School of Medicine

Charlottesville, Virginia, United States

University of Virginia Center for Addiction Education and Treatment (UVA CARE)

Charlottesville, Virginia, United States

Countries

United States

References

Gunderson EW, Haughey HM, Ait-Daoud N, Joshi AS, Hart CL. A survey of synthetic cannabinoid consumption by current cannabis users. Subst Abus. 2014;35(2):184-9. doi: 10.1080/08897077.2013.846288.

Reference Type: DERIVED

PMID: 24821356 (View on PubMed)

Other Identifiers

R01DA027131

Identifier Type: NIH

Identifier Source: secondary_id

View Link

14392

Identifier Type: -

Identifier Source: org_study_id