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Pharmacogenetics, Emotional Reactivity and Smoking

This study is currently recruiting participants.
Verified by M.D. Anderson Cancer Center, August 2008

Sponsors and Collaborators: M.D. Anderson Cancer Center
National Institutes of Health (NIH)
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00507728
  Purpose

Recent advances in smoking cessation have focused on the use of Varenicline and antidepressants (e.g., Bupropion) for the treatment of nicotine dependence. While the efficacy of these treatments has been established in previous studies, we know little about how they work. The specific aims of this project are to assess the effects of these drugs on changes in emotional reactivity during cessation, to determine if these effects are moderated by genotype, and to determine whether emotional reactivity predicts time to relapse. A standardized laboratory assessment procedure, known as the acoustic startle probe, will be used to assess emotional reactivity. In this study, 375 smokers will be randomly assigned to receive Bupropion, Varenicline or placebo. Participants will complete three startle assessments consisting of the presentation of an acoustic stimulus (startle probe), immediately preceded by positive, negative or neutral emotional cues or smoking related stimuli. We hypothesize that the emotional reactivity of all smokers during cessation will be significantly less for those treated with either Varenicline or Bupropion in comparison to placebo. It is also hypothesized that emotional reactivity will be lower for those carrying the DRD2 A1 allele and using Varenicline vs. A1 smokers using either Bupropion or placebo. Homozygous A2s are expected to respond similarly to both drugs with higher levels of emotional reactivity being observed for placebo. We will also characterize other potential markers for neurotransmitter function (DRD4, DAT, SERT, NET) in terms of differences in both baseline emotional reactivity, and response to pharmacotherapy vs. the control. We hope to understand more fully how pharmacotherapies for smoking cessation affect emotional reactivity during cessation (nicotine withdrawal) and what role genetics may play in conferring an advantage to one treatment vs. another, through this mechanism.


Condition Intervention Phase
Tobacco Use Disorder
Smoking Cessation
Drug: Bupropion
Drug: Varenicline
Drug: Placebo
Behavioral: Smoking Cessation Counseling
Phase II
Phase III

MedlinePlus related topics:   Smoking    Smoking Cessation   

ChemIDplus related topics:   Varenicline    Bupropion hydrochloride    Bupropion   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Randomized, Double Blind (Subject, Investigator), Placebo Control, Parallel Assignment, Efficacy Study
Official Title:   Pharmacogenetics, Emotional Reactivity and Smoking

Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • The goal of this behavioral research study is to learn more about how the drugs Bupropion and Varenicline affect mood and physiological responses in different groups of people as they attempt to quit smoking. [ Time Frame: 5 Years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • To learn how these drugs affect responses related to changes in emotion and whether or not a person's genetic make-up makes a difference in how they respond to the medication. [ Time Frame: 5 Years ] [ Designated as safety issue: No ]

Estimated Enrollment:   375
Study Start Date:   December 2005
Estimated Primary Completion Date:   December 2010 (Final data collection date for primary outcome measure)

Arms Assigned Interventions
1: Experimental
Bupropion
Drug: Bupropion
150 mg PO Daily
Behavioral: Smoking Cessation Counseling
Counseling over 8 months and telephone support calls.
2: Experimental
Varenicline
Drug: Varenicline
0.5 mg PO Daily
Behavioral: Smoking Cessation Counseling
Counseling over 8 months and telephone support calls.
3: Placebo Comparator
Placebo
Drug: Placebo
Placebo by mouth for 12 weeks.
Behavioral: Smoking Cessation Counseling
Counseling over 8 months and telephone support calls.

Show detailed description  Show Detailed Description

  Eligibility
Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

Inclusion Criteria:

  1. Age: 18-65 years old
  2. Smoking: >/= 5 cigarettes per day within the 2 months preceding the screening visit and expired CO greater than or equal to 6 ppm.
  3. Able to follow verbal and written instructions in English and complete all aspects of the study
  4. Have an address and home telephone number where they may be reached
  5. Provide informed consent and agree to all assessments and study procedures
  6. Be the only participant in their household

Exclusion Criteria:

  1. Within the month immediately preceding the screening visit; use of any form of tobacco product other than cigarettes on 3 or more days within a week only if the individual refuses to refrain from non-cigarette tobacco use during the course of this study
  2. Within the month immediately preceding the screening visit; use of marijuana in any form on 3 or more days within a week
  3. Within the two weeks immediately preceding the screening visit, involvement on more than 3 days in any formal smoking cessation activities
  4. Current visual or auditory problems that in the opinion of the investigator would interfere with the completion of study assessments
  5. Treatment on a continuous basis within 2 weeks before the screening visit: any contraindicated medication for Varenicline or Bupropion.
  6. Uncontrolled hypertension or other major contraindications for Bupropion or Varenicline.
  7. Severe renal impairment (<30 ml/min/1.73 m2).
  8. Laboratory evaluations outside normal limits and of potential clinical significance in the opinion of the investigator
  9. Meet current criteria for psychiatric disorders or substance abuse as assessed by the MINI for items A, B, D, I, J, K, L, M and N.
  10. Subject rated as moderate to high on suicidality as assessed by the MINI.
  11. Psychiatric hospitalization within 1 year of screening date.
  12. A positive urine pregnancy test during the screening period.
  13. Pregnant, breast-feeding, or of childbearing potential who is not protected by a medically acceptable, effective method of birth control while enrolled in the study
  14. Use of Varenicline or Bupropion within two weeks before the screening visit.
  15. History of hypersensitivity or allergic reaction to Varenicline, tricyclic antidepressant, Bupropion (Wellbutrin, Zyban) or similar chemical classes or any component of these formulations.
  16. Subject considered by the investigator as unsuitable candidate for receipt of an investigational drug, or unstable to be followed up throughout the entire duration of the study.
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00507728

Contacts
Contact: Paul Cinciripini, PhD     713-792-0919    

Locations
United States, Texas
U.T.M.D. Anderson Cancer Center     Recruiting
      Houston, Texas, United States, 77030
      Principal Investigator: Paul Cinciripini, PhD            

Sponsors and Collaborators
M.D. Anderson Cancer Center
National Institutes of Health (NIH)

Investigators
Principal Investigator:     Paul Cinciripini, PhD     U.T.M.D. Anderson Cancer Center    
  More Information


UT MD Anderson Cancer Center Website  This link exits the ClinicalTrials.gov site
 

Responsible Party:   U.T.M.D. Anderson Cancer Center ( Paul Cinciripini, PhD/Professor )
Study ID Numbers:   2003-1024
First Received:   July 25, 2007
Last Updated:   August 20, 2008
ClinicalTrials.gov Identifier:   NCT00507728
Health Authority:   United States: Institutional Review Board

Keywords provided by M.D. Anderson Cancer Center:
Pharmacogenetics  
Emotional Reactivity  
Smoking Cessation Counseling  
Smoking  
Bupropion
Varenicline
Wellbutrin
Placebo

Study placed in the following topic categories:
Smoking
Dopamine
Mental Disorders
Tobacco Use Disorder
Bupropion
Substance-Related Disorders
Disorders of Environmental Origin

Additional relevant MeSH terms:
Dopamine Uptake Inhibitors
Neurotransmitter Agents
Neurotransmitter Uptake Inhibitors
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Psychotropic Drugs
Pharmacologic Actions
Habits
Therapeutic Uses
Dopamine Agents
Antidepressive Agents, Second-Generation
Central Nervous System Agents
Antidepressive Agents

ClinicalTrials.gov processed this record on September 22, 2008




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