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Sponsors and Collaborators: |
Boston University National Institute on Alcohol Abuse and Alcoholism (NIAAA) |
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Information provided by: | Boston University |
ClinicalTrials.gov Identifier: | NCT00329407 |
This investigation will assess the effectiveness of topiramate in reducing ethanol consumption by alcohol dependent subjects. It also will seek to establish whether topiramate can be safely used in this population including whether it might be subject to abuse by alcohol dependent individuals.
An additional goal of this study is to determine whether gamma amino butyric acid (GABA) concentrations are lower in the frontal cortex (the front of the brain)of alcohol dependent individuals than in matched control subjects, whether topiramate increases GABA levels in the frontal cortex, and whether such increases are associated with decreased alcohol consumption.
Condition | Intervention | Phase |
---|---|---|
Alcoholism |
Drug: Topiramate (Topamax) |
Phase IV |
Study Type: | Interventional |
Study Design: | Treatment, Non-Randomized, Open Label, Historical Control, Single Group Assignment, Efficacy Study |
Estimated Enrollment: | 10 |
Study Start Date: | September 2003 |
Estimated Study Completion Date: | September 2007 |
Estimated Primary Completion Date: | September 2008 (Final data collection date for primary outcome measure) |
Medication Dosing Schedule: Days 1-3 50 mg q PM Days 4-7 50 mg BID Days 8-11 50 mg q AM & 100 mg q PM Days 12-15 100mg BID Days 16-19 100 mg q AM
Alcoholism is a disorder that produces extensive morbidity and mortality. Substantial progress has been made in the development of medications that can help to promote abstinence in alcohol dependent individuals. However, investigations of the most promising drugs, particularly naltrexone and acamprosate, suggest that these agents have at best moderate efficacy and there is a great need for additional medications for the treatment of alcoholism.
The results of a recent study suggest that the administration of the anticonvulsant agent ,topiramate helps alcoholic individuals to maintain abstinence (Johnson et al., 2003). Topiramate administration in Magnetic Resonance Spectroscopy (MRS) studies appears to increase GABA concentrations several fold in the brains of both healthy individuals (Kuzniecky et al., 1998) and in patients receiving anticonvulsant medications (Petroff et al., 1999). Although the mechanism through which topiramate produces this effect is unknown, the possibility exists that this agent, may, by enhancing the activity of brain GABAergic systems, act to reduce ethanol reinforcing actions. The objectives of this study are to determine whether topiramate will reduce the consumption of alcohol in subjects dependent on this substance, as has been previously reported, and to establish whether changes in alcohol consumption correlate with alteration in prefrontal GABA levels. Other study objectives are to assess the abuse liability properties of topiramate in alcohol dependent subjects and to examine the effects of chronic topiramate administration on cognitive functioning.
This will be a thirteen week long open label clinical trial of the effects of topiramate administration on ethanol consumption by alcohol dependent subjects. In addition GABA levels in the frontal cortices of alcohol dependent subjects after three days of abstinence will be compared to levels obtained for these individuals during the tenth week of topiramate administration. Baseline GABA cortical concentrations for alcohol dependent subjects also will be compared with those determined for a matched group of healthy control subjects who will be enrolled in a separate concurrent study.
Subjects will be asked to provide informed consent and then will be screened on the same day to determine if they meet study eligibility criteria.
Subjects will be asked to return to provide two urines over the following week.
Subjects will be asked to remain abstinent for three days. On the third day of abstinence subjects will then undergo MRS imaging for GABA levels in the frontal cortex. Baseline measures of mood, craving, withdrawal, cognitive functioning and physical health will be obtained. In the afternoon they will receive their first dose of medication. Their responses to this medication challenge will be assessed over a 3-hour period.
During the drug treatment phase subjects will be asked to come to the clinic weekly for assessment and manual guided therapy during weeks 1-4 and biweekly during weeks 6-8. On days 68, 69, or 70 of the treatment phase subjects will undergo a second MRS study. On day 85 subjects will be seen at the clinic for a termination visit.
Ages Eligible for Study: | 18 Years to 65 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Exclusion Criteria:
United States, Massachusetts | |
Boston University Dept of Psychiatry Clinical Studies Unit | |
Boston, Massachusetts, United States, 02118 |
Principal Investigator: | Ofra Sarid-Segal, MD | Boston University |
Responsible Party: | Boston University ( Ofra Sarid-Segal, MD ) |
Study ID Numbers: | H-22296 |
Study First Received: | May 22, 2006 |
Last Updated: | December 19, 2007 |
ClinicalTrials.gov Identifier: | NCT00329407 History of Changes |
Health Authority: | United States: Institutional Review Board |
Alcoholism Heavy Drinking Alcohol Dependence |
Anti-Obesity Agents Mental Disorders Alcoholism Substance-Related Disorders Topiramate Disorders of Environmental Origin |
Alcohol-Related Disorders Alcohol Drinking Neuroprotective Agents Anticonvulsants Ethanol |
Physiological Effects of Drugs Disorders of Environmental Origin Neuroprotective Agents Protective Agents Pharmacologic Actions Anti-Obesity Agents Mental Disorders |
Therapeutic Uses Alcoholism Substance-Related Disorders Topiramate Alcohol-Related Disorders Central Nervous System Agents Anticonvulsants |