Safety Assessment of Atomoxetine With MA IV Administration

This study has been terminated.
(End in funding)
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Steve Shoptaw, University of California, Los Angeles
ClinicalTrials.gov Identifier:
NCT01019707
First received: November 24, 2009
Last updated: June 25, 2013
Last verified: June 2013
  Purpose

This is a study of 4 nontreatment seeking individuals who were MA-dependent and the safety and tolerability of atomoxetine. This double-blind, placebo-controlled, within-subjects study is to determine the safety and tolerability of atomoxetine.

MA abusing participants will undergo a 1-day outpatient screening and if it is safe for the participants to proceed with the study they will participate in two inpatient components of the study that will occur in the University of California Los Angeles (UCLA) General Clinical Research Center (GCRC). The first inpatient stay will be 15 days, and the second will be a 9 days stay that includes drug administration and assessments. There will be at least a two week interval between inpatient components. During the inpatient components participants will receive alternating study drugs; atomoxetine or placebo and four sessions of IV MA administration or saline.


Condition Intervention Phase
Methamphetamine Abuse
Methamphetamine Dependence
Drug: Atomoxetine, then Placebo
Drug: Placebo, then Atomoxetine
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety Study
Intervention Model: Crossover Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Study to Assess the Cardiovascular, Cognitive and Subjective Effects of Atomoxetine in Combination With Intravenous Methamphetamine

Resource links provided by NLM:


Further study details as provided by University of California, Los Angeles:

Primary Outcome Measures:
  • Systolic Blood Pressure [ Time Frame: Timepoints post MA infusion ] [ Designated as safety issue: Yes ]
    Based on 8 timepoints post MA infusion, data were pooled and the mean value and standard deviation are presented.

  • Diastolic Blood Pressure [ Time Frame: Timepoints post MA infusion ] [ Designated as safety issue: Yes ]
    Based on 8 timepoints post MA infusion, data were pooled and the mean value and standard deviation are presented.

  • Heart Rate [ Time Frame: Timepoints post MA infusion ] [ Designated as safety issue: Yes ]
    Based on 8 timepoints post MA infusion, data were pooled and the mean value and standard deviation are presented.


Enrollment: 4
Study Start Date: October 2009
Study Completion Date: December 2010
Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Sugar pill
As this is a within-subject, crossover design, all subjects complete both study medication assignments in a double-blind fashion. Based on random assignment to start on either atomoxetine or placebo, study drug will be administered once daily at 40 mg/day on the first 2 study days, then twice daily for the third, fourth and fifth study days, and once daily on the sixth study day.
Drug: Atomoxetine, then Placebo
As this is a within-subject, crossover design, all subjects complete both study medication assignments in a double-blind fashion. Based on random assignment to start on either atomoxetine or placebo, study drug will be administered once daily at 40 mg/day on the first 2 study days, then twice daily for the third, fourth and fifth study days, and once daily on the sixth study day.
Other Name: Strattera
Drug: Placebo, then Atomoxetine
As this is a within-subject, crossover design, all subjects complete both study medication assignments in a double-blind fashion. Based on random assignment to start on either atomoxetine or placebo, study drug will be administered once daily at 40 mg/day on the first 2 study days, then twice daily for the third, fourth and fifth study days, and once daily on the sixth study day.
Active Comparator: Atomoxetine
As this is a within-subject, crossover design, all subjects complete both study medication assignments in a double-blind fashion. Based on random assignment to start on either atomoxetine or placebo, study drug will be administered once daily at 40 mg/day on the first 2 study days, then twice daily for the third, fourth and fifth study days, and once daily on the sixth study day.
Drug: Atomoxetine, then Placebo
As this is a within-subject, crossover design, all subjects complete both study medication assignments in a double-blind fashion. Based on random assignment to start on either atomoxetine or placebo, study drug will be administered once daily at 40 mg/day on the first 2 study days, then twice daily for the third, fourth and fifth study days, and once daily on the sixth study day.
Other Name: Strattera
Drug: Placebo, then Atomoxetine
As this is a within-subject, crossover design, all subjects complete both study medication assignments in a double-blind fashion. Based on random assignment to start on either atomoxetine or placebo, study drug will be administered once daily at 40 mg/day on the first 2 study days, then twice daily for the third, fourth and fifth study days, and once daily on the sixth study day.

Detailed Description:

The safety of using atomoxetine in MA users will be characterized by measuring the cardiovascular effects of MA and by determining the occurrence of adverse reactions during treatment with atomoxetine and placebo. We will evaluate atomoxetine (0 and 40 mg, BID) and MA doses (0 and 30 mg, IV).

Participants will be randomized to atomoxetine or matched placebo for 6 days. Study drug will be administered once daily at 40 mg/day on the first two study days, twice daily for days 3-5, & once on day 6. After discharge from the first component, and at least a 2-week washout period, participants will be re-admitted to the UCLA GCRC and switched to the opposite study medication for an additional 6 days.

Methamphetamine/saline will be administered non-contingently on component I day 13, and component II day 7, over 1 min using a syringe pump activated by the study physician or nurse practitioner in order to assess safety and tolerability of atomoxetine. During drug administration sessions, heart rate and blood pressure will be monitored frequently. A code team will respond if required. Vital signs must remain within values specified under Stopping Criteria for initiation of MA administration. The physician or nurse practitioner will administer the MA/placebo and will be available in-house on pager for at least 4 h after each infusion. In addition, heart rate and blood pressure will be assessed three times daily throughout the inpatient portion of the protocol.

  Eligibility

Ages Eligible for Study:   18 Years to 50 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Be fluently English-speaking volunteers who meet DSM-IV criteria for MA abuse or dependence.
  2. Be between 18 and 50 years of age.
  3. Be able to verbalize understanding of consent form, able to provide written informed consent, and verbalize willingness to complete study procedures.
  4. Have smoked or injected methamphetamine for more than two years.
  5. Produce a methamphetamine-positive urine prior to study entry.
  6. Have vital signs as follows: resting pulse between 50 and 90 bpm, blood pressures between 105-150mm Hg systolic and 45-90mm Hg diastolic. Note that a blood pressure of 150/90 and pulse of 90 is too high for randomization but will allow participants to be enrolled if an acceptable range is demonstrated on a separate occasion.
  7. Have an ECG performed that demonstrates normal sinus rhythm, normal conduction, and no clinically significant arrhythmias.
  8. Agree to abstain from MA during the study, evidenced by a MA-negative urine each morning of the study.
  9. If female, have a negative pregnancy test and agree to use one of the following methods of birth control, or be postmenopausal, have had a hysterectomy or have been sterilized.

    1. oral contraceptives
    2. barrier (diaphragm or condom) with spermicide, or condom only
    3. intrauterine progesterone,or non-hormonal contraceptive system
    4. levonorgestrel implant
    5. medroxyprogesterone acetate contraceptive injection
    6. complete abstinence from sexual intercourse

NOTE: Recent intermittent alcohol or other illicit drug use without physical dependence is allowable (however a benzodiazepine-free urine should be produced to document absence of recent use).

Exclusion Criteria:

  1. A current or past history of seizure disorder, including alcohol- or stimulant-related seizure, febrile seizure, or significant family history of idiopathic seizure disorder.
  2. A history of head trauma that resulted in neurological sequelae (e.g., with loss of consciousness [LOC] > 15 minutes, or that required hospitalization. Also, individuals with 3 or more head injuries with LOC > 5 minutes will be excluded).
  3. Do not meet DSM-IV criteria (by SCID) for drug dependence other than meth, with the exception of nicotine and/or marijuana dependence.
  4. Any previous medically serious adverse reaction to MA including loss of consciousness, chest pain, or epileptic seizure resulting in hospitalization.
  5. Meeting diagnostic criteria or receiving psychopharmacological treatment for the following Axis I disorders within the last 6 months: anorexia nervosa, bulimia, psychosis, bipolar I disorder, organic brain disease, dementia, major depression, schizoaffective disorder, or schizophrenia.
  6. Evidence of clinically significant heart disease, hypertension or significant medical illness.
  7. Have any history of hypersensitivity to atomoxetine, glaucoma, motor tics or with a family history or diagnosis of Tourette's syndrome.
  8. Have any preexisting severe gastrointestinal narrowing, small bowel inflammatory disease, intestinal adhesions, past history of peritonitis, or cystic fibrosis.
  9. Be pregnant or nursing.
  10. Have a significant family history of early cardiovascular morbidity or mortality.
  11. Have a diagnosis of adult asthma, including those with a history of acute asthma within the past two years, and those with current or recent (past 2 years) treatment with inhaled or oral beta-agonist or steroid therapy (due to potential serious adverse interactions with methamphetamine).
  12. Be actively using albuterol or other beta agonist medications, regardless of formal diagnosis of asthma. (Inhalers are sometimes used by MA addicts to enhance MA delivery to the lungs.) If respiratory disease is excluded and the subject will consent to discontinue agonist use, s/he may be considered for inclusion.
  13. For subjects suspect for asthma but without formal diagnosis, 1) have a history of coughing and/or wheezing, 2) have a history of asthma and/or asthma treatment two or more years before, 3) have a history of other respiratory illness, e.g., complications of pulmonary disease (exclude if on beta agonists), 4) use over-the-counter agonist or allergy medication for respiratory problems (e.g., Primatene Mist): a detailed history and physical exam, pulmonary consult, and pulmonary function tests should be performed prior to including or excluding from the study or 5) have an FEV1 <70 %.
  14. Have any illness, condition, and/or use of medications that in the opinion of the site Principal Investigator and the admitting physician would preclude safe and/or successful completion of the study.
  15. Have active syphilis that has not been treated or refuse treatment for syphilis.
  16. Be undergoing HIV treatment with antiviral and non-antiviral therapy.
  17. Have AIDS according to the current CDC criteria for AIDS - MMWR 1999;48 (#RR-13:29-31).
  18. Have neurological disorders including Parkinson's disease.
  19. Have evidence of significant liver or kidney dysfunction.
  20. Have a history of urinary retention or bladder outlet obstruction.
  21. Be UCLA students or staff.
  22. Have evidence of active tuberculosis infection.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01019707

Locations
United States, California
UCLA Semel Institute NPI
Los Angeles, California, United States, 90095
Sponsors and Collaborators
University of California, Los Angeles
Investigators
Principal Investigator: Steven Shoptaw, PhD University of California, Los Angeles
  More Information

No publications provided

Responsible Party: Steve Shoptaw, Professor, University of California, Los Angeles
ClinicalTrials.gov Identifier: NCT01019707     History of Changes
Other Study ID Numbers: P50-18185-PI-EDL-A, P50DA018185, DPMC
Study First Received: November 24, 2009
Results First Received: April 2, 2013
Last Updated: June 25, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by University of California, Los Angeles:
crystal meth
methamphetamine
substance abuse

Additional relevant MeSH terms:
Atomoxetine
Methamphetamine
Adrenergic Agents
Adrenergic Uptake Inhibitors
Autonomic Agents
Central Nervous System Agents
Central Nervous System Stimulants
Dopamine Agents
Dopamine Uptake Inhibitors
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Neurotransmitter Uptake Inhibitors
Peripheral Nervous System Agents
Pharmacologic Actions
Physiological Effects of Drugs
Sympathomimetics
Therapeutic Uses

ClinicalTrials.gov processed this record on October 23, 2014