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Human Laboratory Study of Varenicline and Bupropion for Nicotine Dependence (ChanBan)

This study is not yet open for participant recruitment.
Verified by National Institute on Drug Abuse (NIDA), September 2008

Sponsored by: Pfizer
Information provided by: National Institute on Drug Abuse (NIDA)
ClinicalTrials.gov Identifier: NCT00749658
  Purpose

The objective of this proposal is to elucidate effects of bupropion SR + varenicline on smoking-cessation related processes in early abstinence using a human laboratory model. A within-subjects design will be used to assess the additive effects of bupropion and varenicline in 48 treatment seeking smokers [bupropion SR (300 mg/day)+placebo, varenicline (2 mg/day+placebo, and bupropion SR (300 mg/day)+varenicline (2 mg/day)]. Outcomes include withdrawal and craving, cognition, stress tolerance, anxiety, the reinforcing effects of smoking, and smoking topography.

Hypotheses: We hypothesize that greatest treatment effects will be observed in the bupropion SR+varenicline group followed by varenicline+placebo and bupropion SR+placebo groups.


Condition Intervention Phase
Nicotine Dependence
Nicotine Withdrawal
Drug: Bupropion SR
Drug: Varenicline
Phase II
Phase III

MedlinePlus related topics:   Smoking    Stress   

Drug Information available for:   Varenicline    Bupropion hydrochloride    Bupropion    Nicotine polacrilex    Nicotine tartrate   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Randomized, Double Blind (Subject, Investigator), Active Control, Crossover Assignment, Efficacy Study
Official Title:   Human Laboratory Study of Varenicline and Bupropion for Nicotine Dependence

Further study details as provided by National Institute on Drug Abuse (NIDA):

Primary Outcome Measures:
  • Nicotine withdrawal and craving [ Time Frame: All visits ] [ Designated as safety issue: No ]
  • Attention and concentration [ Time Frame: 3 human laboratory visits ] [ Designated as safety issue: No ]
  • Psychophysiology [ Time Frame: 2 human laboratory visits ] [ Designated as safety issue: No ]
  • Stress Tolerance [ Time Frame: 2 human laboratory visits ] [ Designated as safety issue: No ]
  • Motivation to smoke [ Time Frame: 2 human laboratory visits ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Medication side effects [ Time Frame: All visits ] [ Designated as safety issue: Yes ]

Estimated Enrollment:   48
Study Start Date:   November 2008
Estimated Study Completion Date:   October 2010
Estimated Primary Completion Date:   August 2010 (Final data collection date for primary outcome measure)

Arms Assigned Interventions
1: Active Comparator
Order 1: Bupropion + Placebo Varenicline \Varenicline + Placebo Bupropion; Order 2: Varenicline + Placebo Bupropion \Bupropion + Placebo Varenicline
Drug: Bupropion SR
Form: tablet, Dosage, Frequency, Duration: Days 1-3, 150 mg, q.d., Days 4-11, 150 mg, b.i.d.
Drug: Varenicline
Form: tablet, Dosage, Frequency, Duration: Days 1-3, .5 mg, q.d., Days 4-7, .5 mg, b.i.d., Days 8-11, 1 mg, b.i.d.
2: Active Comparator
Order 1: Bupropion + Varenicline \Varenicline + Placebo Bupropion; Order 2: Varenicline + Placebo Bupropion \Bupropion + Varenicline
Drug: Bupropion SR
Form: tablet, Dosage, Frequency, Duration: Days 1-3, 150 mg, q.d., Days 4-11, 150 mg, b.i.d.
Drug: Varenicline
Form: tablet, Dosage, Frequency, Duration: Days 1-3, .5 mg, q.d., Days 4-7, .5 mg, b.i.d., Days 8-11, 1 mg, b.i.d.
3: Active Comparator
Order 1: Bupropion + Varenicline \Bupropion + Placebo Varenicline; Order 2: Bupropion+ Placebo Varenicline \Bupropion + Varenicline
Drug: Bupropion SR
Form: tablet, Dosage, Frequency, Duration: Days 1-3, 150 mg, q.d., Days 4-11, 150 mg, b.i.d.
Drug: Varenicline
Form: tablet, Dosage, Frequency, Duration: Days 1-3, .5 mg, q.d., Days 4-7, .5 mg, b.i.d., Days 8-11, 1 mg, b.i.d.

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes

Criteria

Inclusion Criteria:

  1. 18 years and up.
  2. Smoked at least 10 cigarettes/day for at least 1 year.
  3. English speaking and reading.
  4. Females who are of childbearing potential must practice effective contraception and meet the following criteria:

    1. Are instructed to avoid pregnancy through 30 days after the last dose of study medication.
    2. Have a negative urine pregnancy test at baseline.
    3. Agree to use of the birth control methods listed: an oral contraceptive agent, an intrauterine device (IUD), an implantable contraceptive (e.g., Norplant), or an injectable contraceptive (e.g., Depo-Provera) for at least one month prior to entering the study and will continue its use through at least 30 days after the last dose of the study medication. A barrier method of contraception (e.g., condom or diaphragm with spermicide) while participating in the study and 30 days after the last dose of study medication.
  5. Willingness to not use illicit drugs during study period including marijuana.

Exclusion Criteria:

  1. Any unstable medical condition.
  2. Unstable angina, myocardial infarction, or coronary angioplasty within the past 3 months or an untreated cardiac dysrhythmia.
  3. Personal history of seizures.
  4. Closed head trauma with any loss of consciousness or amnesia in the last 5 years.
  5. A history of closed head trauma with > 30 minutes of loss of consciousness or amnesia or resulting in skull fracture or subdural hematoma/brain contusion.
  6. A history of psychosis, bipolar disorder, bulimia or anorexia nervosa.
  7. Current depression as assessed by Center for Epidemiologic Studies Depression Scale (CES-D).
  8. Medications that might affect the outcome measures of nicotine reward, cognition, anxiety, and stress will also be a basis for exclusion. These medications include psychotropic drugs (i.e., anti-psychotic, anti-depressant, anti-anxiety, or stimulant), anti- hypertensive agents (e.g., beta-blockers), and other drugs that can influence the outcome domains.
  9. Active substance abuse other than nicotine.
  10. Used an investigational drug within the last 30 days.
  11. Are currently using a behavioral or pharmacologic tobacco treatment.
  12. Use of bupropion or varenicline in the previous 30 days.
  13. Current (past 14 days) use of antipsychotic or antidepressant medications.
  14. An allergy to bupropion or varenicline.
  15. Untreated hypertension or baseline systolic blood pressure > 180 or diastolic > 100.
  16. Impaired kidney function (creatinine clearance < 30).
  17. Having plans to leave the immediate geographical area within 2 months.
  18. Unwillingness or inability to give written informed consent.

    -

  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00749658

Contacts
Contact: Marc E Mooney, Ph.D.     612-627-1822     moon0078@umn.edu    
Contact: Andrew Oliver, B.A.     612-627-4905     oliv0190@umn.edu    

Locations
United States, Minnesota
University of Minnesota, Tobacco Use Research Center    
      Minneapolis, Minnesota, United States, 55414

Sponsors and Collaborators
Pfizer

Investigators
Principal Investigator:     Marc E Mooney, Ph.D.     University of Minnesota    
  More Information


Tobacco Use Research Center  This link exits the ClinicalTrials.gov site
 

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Cinciripini PM, Tsoh JY, Wetter DW, Lam C, de Moor C, Cinciripini L, Baile W, Anderson C, Minna JD. Combined effects of venlafaxine, nicotine replacement, and brief counseling on smoking cessation. Exp Clin Psychopharmacol. 2005 Nov;13(4):282-92.
 
Croghan GA, Sloan JA, Croghan IT, Novotny P, Hurt RD, DeKrey WL, Mailliard JA, Ebbert LP, Swan DK, Walsh DJ, Wiesenfeld M, Levitt R, Stella P, Johnson PA, Tschetter LK, Loprinzi C. Comparison of nicotine patch alone versus nicotine nasal spray alone versus a combination for treating smokers: a minimal intervention, randomized multicenter trial in a nonspecialized setting. Nicotine Tob Res. 2003 Apr;5(2):181-7.
 
Croghan IT, Hurt RD, Dakhil SR, Croghan GA, Sloan JA, Novotny PJ, Rowland KM, Bernath A, Loots ML, Le-Lindqwister NA, Tschetter LK, Garneau SC, Flynn KA, Ebbert LP, Wender DB, Loprinzi CL. Randomized comparison of a nicotine inhaler and bupropion for smoking cessation and relapse prevention. Mayo Clin Proc. 2007 Feb;82(2):186-95.
 
Evins AE, Cather C, Culhane MA, Birnbaum A, Horowitz J, Hsieh E, Freudenreich O, Henderson DC, Schoenfeld DA, Rigotti NA, Goff DC. A 12-week double-blind, placebo-controlled study of bupropion sr added to high-dose dual nicotine replacement therapy for smoking cessation or reduction in schizophrenia. J Clin Psychopharmacol. 2007 Aug;27(4):380-6.
 
Fagerström KO, Tönnesen P. Nicotine chewing gum and nicotine patch. Wien Med Wochenschr. 1995;145(4):77-82. Review.
 
Hall SM, Humfleet GL, Reus VI, Muñoz RF, Cullen J. Extended nortriptyline and psychological treatment for cigarette smoking. Am J Psychiatry. 2004 Nov;161(11):2100-7.
 
Jorenby DE, Leischow SJ, Nides MA, Rennard SI, Johnston JA, Hughes AR, Smith SS, Muramoto ML, Daughton DM, Doan K, Fiore MC, Baker TB. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med. 1999 Mar 4;340(9):685-91.
 
Killen JD, Fortmann SP, Schatzberg AF, Hayward C, Sussman L, Rothman M, Strausberg L, Varady A. Nicotine patch and paroxetine for smoking cessation. J Consult Clin Psychol. 2000 Oct;68(5):883-9.
 
Killen JD, Robinson TN, Ammerman S, Hayward C, Rogers J, Stone C, Samuels D, Levin SK, Green S, Schatzberg AF. Randomized clinical trial of the efficacy of bupropion combined with nicotine patch in the treatment of adolescent smokers. J Consult Clin Psychol. 2004 Aug;72(4):729-35.
 
Kornitzer M, Boutsen M, Dramaix M, Thijs J, Gustavsson G. Combined use of nicotine patch and gum in smoking cessation: a placebo-controlled clinical trial. Prev Med. 1995 Jan;24(1):41-7.
 
Krishnan-Sarin S, Meandzija B, O'Malley S. Naltrexone and nicotine patch smoking cessation: a preliminary study. Nicotine Tob Res. 2003 Dec;5(6):851-7.
 
O'Malley SS, Cooney JL, Krishnan-Sarin S, Dubin JA, McKee SA, Cooney NL, Blakeslee A, Meandzija B, Romano-Dahlgard D, Wu R, Makuch R, Jatlow P. A controlled trial of naltrexone augmentation of nicotine replacement therapy for smoking cessation. Arch Intern Med. 2006 Mar 27;166(6):667-74.
 
Piper ME, Federman EB, McCarthy DE, Bolt DM, Smith SS, Fiore MC, Baker TB. Efficacy of bupropion alone and in combination with nicotine gum. Nicotine Tob Res. 2007 Sep;9(9):947-54.
 
Rose JE, Behm FM, Westman EC. Nicotine-mecamylamine treatment for smoking cessation: the role of pre-cessation therapy. Exp Clin Psychopharmacol. 1998 Aug;6(3):331-43.
 
Williams J, Ziedonis DM. Naltrexone-bupropion combination therapy for protracted abstinence dysphoria. Am J Addict. 2003 May-Jun;12(3):270-2. No abstract available.
 
Rose JE, Levin ED. Concurrent agonist-antagonist administration for the analysis and treatment of drug dependence. Pharmacol Biochem Behav. 1992 Jan;41(1):219-26. Review.
 
Ascher JA, Cole JO, Colin JN, Feighner JP, Ferris RM, Fibiger HC, Golden RN, Martin P, Potter WZ, Richelson E, et al. Bupropion: a review of its mechanism of antidepressant activity. J Clin Psychiatry. 1995 Sep;56(9):395-401. Review.
 
Coe JW, Brooks PR, Vetelino MG, Wirtz MC, Arnold EP, Huang J, Sands SB, Davis TI, Lebel LA, Fox CB, Shrikhande A, Heym JH, Schaeffer E, Rollema H, Lu Y, Mansbach RS, Chambers LK, Rovetti CC, Schulz DW, Tingley FD 3rd, O'Neill BT. Varenicline: an alpha4beta2 nicotinic receptor partial agonist for smoking cessation. J Med Chem. 2005 May 19;48(10):3474-7.
 
Mooney ME, Sofuoglu M. Bupropion for the treatment of nicotine withdrawal and craving. Expert Rev Neurother. 2006 Jul;6(7):965-81. Review.
 
Warner C, Shoaib M. How does bupropion work as a smoking cessation aid? Addict Biol. 2005 Sep;10(3):219-31. Review.
 
Johnston AJ, Ascher J, Leadbetter R, Schmith VD, Patel DK, Durcan M, Bentley B. Pharmacokinetic optimisation of sustained-release bupropion for smoking cessation. Drugs. 2002;62 Suppl 2:11-24. Review.
 
Bondarev ML, Bondareva TS, Young R, Glennon RA. Behavioral and biochemical investigations of bupropion metabolites. Eur J Pharmacol. 2003 Aug 1;474(1):85-93.
 
Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003 Feb;5(1):13-25. Erratum in: Nicotine Tob Res. 2003 Aug;5(4):603.
 
SRNT Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002 May;4(2):149-59. No abstract available.
 
Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991 Sep;86(9):1119-27.
 
Shiffman S, Johnston JA, Khayrallah M, Elash CA, Gwaltney CJ, Paty JA, Gnys M, Evoniuk G, DeVeaugh-Geiss J. The effect of bupropion on nicotine craving and withdrawal. Psychopharmacology (Berl). 2000 Jan;148(1):33-40.
 
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Responsible Party:   University of Minnesota ( Marc E. Mooney, Ph.D./Assistant Professor of Psychiatry )
Study ID Numbers:   GCRC 10047
First Received:   September 5, 2008
Last Updated:   September 5, 2008
ClinicalTrials.gov Identifier:   NCT00749658
Health Authority:   United States: Federal Government

Keywords provided by National Institute on Drug Abuse (NIDA):
Tobacco  
Nicotine  
Smoking  
Varenicline  
Bupropion  
Human laboratory study  
Stress tolerance
Startle response
Cognitive assessment
Progressive ratio
Stress tolerance
Motivation

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

Additional relevant MeSH terms:
Dopamine Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Neurotransmitter Agents
Cholinergic Agonists
Molecular Mechanisms of Pharmacological Action
Nicotinic Agonists
Physiological Effects of Drugs
Psychotropic Drugs
Cholinergic Agents
Pharmacologic Actions
Autonomic Agents
Therapeutic Uses
Ganglionic Stimulants
Dopamine Agents
Peripheral Nervous System Agents
Antidepressive Agents, Second-Generation
Central Nervous System Agents
Antidepressive Agents

ClinicalTrials.gov processed this record on November 05, 2008




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