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Sweet Preference and Alcohol Craving

NCT ID: NCT01296646

Last Updated: 2013-11-25

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-01-31

Study Completion Date

2012-06-30

Brief Summary

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Purpose: The proposed 2-year investigation will be the first double-blind, placebo-controlled trial examining the hedonic response to sweet taste (HRST) as a phenotypic predictor of naltrexone (NTX) response in alcohol dependence. HRST yields two primary phenotypes-Sweet Likers (SL) and Sweet Dislikers (SDL). Based on preliminary findings, HRST will be examined in conjunction with craving for alcohol to assess whether the two factors together provide a more robust predictor of NTX response. The identification of methods to predict naltrexone response in alcohol dependence is an important goal for alcohol treatment research. Currently naltrexone is not being used nearly as much as it should be, in part because clinicians do not believe it is very effective. The development of tools that would identify which patients are more likely to have a robust response to naltrexone should lead to increased use of the medication. This could help many patients who are not now having the opportunity of trying naltrexone.

There are two principal Specific Aims for the study:

Specific Aim 1. To test the hypothesis that a combination of SL/SDL status and initial alcohol craving will predict % abstinent days (%ABST) during treatment with naltrexone.

Specific Aim 2. To test whether a combination of SL/SDL status and initial alcohol craving predict % heavy drinking days (%HDD) during treatment with naltrexone.

Detailed Description

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Participants: There will be 130 alcohol-dependent individuals between 18 and 65 years of age recruited to participate in this randomized placebo-controlled clinical trial. Eighty alcohol-dependent individuals will be randomized into the study and we are allowing for 50 screen failures. Participation in this study will be an alternative to standard treatment. Subjects will be blindly assessed for SL/SDL status to yield 50% representation of each trait.

Procedures (methods): Subjects who meet general inclusion/exclusion criteria based on the screening interview will complete a sweet taste assessment. Results, along with craving score, will be given to the Investigational Drug Services for randomization purposes. The study is a double-blind, randomized, placebo-controlled clinical trial in which participants will receive 50 mg oral naltrexone or matching placebo for a 12-week period. In addition participants will meet with a trained therapist for nine 30-minute BRENDA therapy sessions Medical monitoring will also be conducted by study physicians and will consist of review of vital signs, concomitant medication use, and general inquiries into side effects.

Conditions

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Alcohol Dependence Alcohol Abuse

Keywords

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Alcohol Alcoholics Substance Abuse Alcohol Abuse Alcohol Addiction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Arm 1

Sweet Liker, High Craver Half of this group will be on naltrexone the other half will be on placebo. All subjects will receive Brenda Therapy Sessions

Group Type ACTIVE_COMPARATOR

Naltrexone

Intervention Type DRUG

50 mg oral naltrexone once/day

Brenda Therapy Sessions

Intervention Type BEHAVIORAL

participants will meet with a trained therapist for nine 30-minute BRENDA therapy sessions Medical monitoring will also be conducted by study physicians and will consist of review of vital signs, concomitant medication use, and general inquiries into side effects.

Placebo

Intervention Type DRUG

An inactive pill to control for non-pharmacological responses.

Arm 2

Sweet Liker - Low Craver Half of this group will be on naltrexone the other half will be on placebo. All subjects will receive Brenda Therapy Sessions

Group Type ACTIVE_COMPARATOR

Naltrexone

Intervention Type DRUG

50 mg oral naltrexone once/day

Brenda Therapy Sessions

Intervention Type BEHAVIORAL

participants will meet with a trained therapist for nine 30-minute BRENDA therapy sessions Medical monitoring will also be conducted by study physicians and will consist of review of vital signs, concomitant medication use, and general inquiries into side effects.

Placebo

Intervention Type DRUG

An inactive pill to control for non-pharmacological responses.

Arm 3

Sweet Disliker - High Craver. Half of this group will be on naltrexone the other half will be on Placebo. All subjects will receive Brenda Therapy Sessions

Group Type ACTIVE_COMPARATOR

Naltrexone

Intervention Type DRUG

50 mg oral naltrexone once/day

Brenda Therapy Sessions

Intervention Type BEHAVIORAL

participants will meet with a trained therapist for nine 30-minute BRENDA therapy sessions Medical monitoring will also be conducted by study physicians and will consist of review of vital signs, concomitant medication use, and general inquiries into side effects.

Placebo

Intervention Type DRUG

An inactive pill to control for non-pharmacological responses.

Arm 4

Sweet Disliker - Low Craver; half of this group will be on naltrexone the other half on placebo. All subjects will receive Brenda Therapy Sessions

Group Type ACTIVE_COMPARATOR

Naltrexone

Intervention Type DRUG

50 mg oral naltrexone once/day

Brenda Therapy Sessions

Intervention Type BEHAVIORAL

participants will meet with a trained therapist for nine 30-minute BRENDA therapy sessions Medical monitoring will also be conducted by study physicians and will consist of review of vital signs, concomitant medication use, and general inquiries into side effects.

Placebo

Intervention Type DRUG

An inactive pill to control for non-pharmacological responses.

Interventions

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Naltrexone

50 mg oral naltrexone once/day

Intervention Type DRUG

Brenda Therapy Sessions

participants will meet with a trained therapist for nine 30-minute BRENDA therapy sessions Medical monitoring will also be conducted by study physicians and will consist of review of vital signs, concomitant medication use, and general inquiries into side effects.

Intervention Type BEHAVIORAL

Placebo

An inactive pill to control for non-pharmacological responses.

Intervention Type DRUG

Other Intervention Names

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Revia Counselling Therapy Sessions Medical Management "Sugar pill"

Eligibility Criteria

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Inclusion Criteria

1. Men and women between the ages of 18 and 65 meeting DSM-IV criteria for current alcohol dependence.
2. More than 14 drinks (women) or 21 drinks (men) per week including at least 2 heavy drinking days/week on average (men \> 5 drinks/day; women \> 4 drinks/day) during a consecutive 30-day period within the 90 days prior to screening.
3. Ability to understand and sign written informed consent.
4. Must have a 0.0 gms/dL breathalyzer reading on the day of screening and 0.0 gms/dL on the day of randomization.
5. Must be willing to refrain from drinking for three days prior to randomization day.
6. Express a desire to achieve abstinence or to greatly reduce alcohol consumption.
7. Must have a stable residence and be able to identify an individual who could locate subject if needed.

Exclusion Criteria

1. Clinically significant medical disease that might interfere with the evaluation of the study medication or present a safety concern (e.g., cirrhosis, unstable hypertension, seizure disorder, use of opiate medication).
2. Clinically significant psychiatric illness including: any psychotic disorder, bipolar disorder, severe depression, or suicidal ideation.
3. Other substance abuse or dependence disorder other than nicotine or alcohol.
4. Concurrent use of any psychotropic medication including antidepressants, mood stabilizers, antipsychotics, anxiolytics, stimulants, or hypnotics with the exception of stable doses of antidepressants for one month.
5. History of complicated alcohol withdrawal, i.e. withdrawal seizure or delirium tremens.
6. AST, or ALT \> 3 times Upper Limit of Normal (ULN) or bilirubin \> ULN.
7. Positive urine toxicology screen with the exception of cannabis. Individuals with positive cannabis screens will be excluded only if they have a history of cannabis dependence.
8. Pregnant women and women of childbearing potential who do not practice a medically acceptable form of birth control (oral or depot contraceptive, or barrier methods such as diaphragm or condom with spermicidal) and women who are breast feeding.
9. Individuals requiring inpatient treatment or more intense outpatient treatment for their alcohol dependence.
10. Participation in any clinical trial within the past 60 days.
11. Court-mandated participation in alcohol treatment or pending incarceration.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Alcohol Abuse and Alcoholism (NIAAA)

NIH

Sponsor Role collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role lead

Responsible Party

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James Garbutt, MD

Professor of Psychiatry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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James C Garbutt, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of North Carolina, Chapel Hill

Locations

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University of North Carolina - Chapel Hill

Chapel Hill, North Carolina, United States

Site Status

Countries

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United States

References

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Garbutt JC, Kampov-Polevoy AB, Kalka-Juhl LS, Gallop RJ. Association of the Sweet-Liking Phenotype and Craving for Alcohol With the Response to Naltrexone Treatment in Alcohol Dependence: A Randomized Clinical Trial. JAMA Psychiatry. 2016 Oct 1;73(10):1056-1063. doi: 10.1001/jamapsychiatry.2016.2157.

Reference Type DERIVED
PMID: 27627782 (View on PubMed)

Other Identifiers

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1R21AA017503-01A2

Identifier Type: NIH

Identifier Source: secondary_id

View Link

09-0939

Identifier Type: -

Identifier Source: org_study_id