Modafinil, DRD4 Genotype and Cocaine Relapse
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Purpose
Treatment for cocaine dependence is characterized by high rates of relapse, yet the factors influencing the likelihood of relapse are poorly understood. Exposure to cocaine, stress and cocaine-related cues increase cocaine craving, and genetic polymorphisms in the dopamine D4 receptor subtype (DRD4) influence the effects of cues and drug exposure on ratings of craving. However, craving does not robustly predict drug use or relapse. There are currently no data characterizing the interaction between DRD4 polymorphisms, cues and cocaine exposure on actual cocaine taking, i.e., cocaine self-administration. Incorporating measures of relapse into our established laboratory model is an important objective for medications development because models of cocaine self-administration have predictive validity in screening medications for cocaine dependence. Aim 1: Refine our cocaine self-administration procedures to include measures of relapse. The model is guided by hypotheses supported by pilot data: The likelihood of relapse and the quantity of cocaine self-administered following relapse will vary as a function of (1) the cost of cocaine, (2) the presence of contextual cues associated with cocaine-taking, and (3) noncontingent cocaine administration (i.e., 'priming'). Aim 2: Determine the influence of DRD4 polymorphisms on cue- and cocaine-induced relapse. Data with alcohol have demonstrated that individuals heterozygous or homozygous for 7 or more allele repeats (DRD4L) show increased cue- and alcohol-induced craving and greater relapse clinically than those with fewer than 7 allele repeats (DRD4 S). We hypothesize that cocaine-dependent DRD4 L volunteers will show greater cue- and prime-induced relapse compared to the DRD4 S group. Aim 3: Test the effects of modafinil on measures of cocaine relapse as a function of DRD4 polymorphisms. We hypothesize that modafinil will: (1) decrease the effect of both cues and a cocaine prime on the likelihood of relapse compared to placebo, (2) decrease the amount of cocaine self-administered if cocaine use is initiated, and (3) be more effective decreasing cue-and cocaine-induced relapse in the DRD4 L group than the DRD4 S group.
This study will provide valuable information about the interaction between genetic variability, modafinil and environmental factors believed to increase cocaine relapse.
| Condition | Intervention | Phase |
|---|---|---|
|
Cocaine Dependence |
Drug: Modafinil |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Pharmacodynamics Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Caregiver) Primary Purpose: Treatment |
| Official Title: | Modafinil and DRD4 Genotype in a Human Laboratory Model of Cocaine Relapse |
- Cocaine self-administration [ Time Frame: Four years ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | March 2009 |
| Estimated Study Completion Date: | June 2013 |
| Estimated Primary Completion Date: | March 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: placebo, modafinil
Modafinil (150 mg bid) or placebo for 21 days.
|
Drug: Modafinil
Modafinil (300 mg) administration for 3 weeks
Other Name: Provigil
Drug: Modafinil
Modafinil (300 mg/day) for 3 weeks
Other Name: Provigil
|
Detailed Description:
Provide a more extensive description, if desired. I do not desire to.
Eligibility| Ages Eligible for Study: | 21 Years to 50 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Smokes cocaine
- Has patterns of smoked cocaine use in terms of frequency and amount which parallel or exceed those administered in the study.
- Age 21-50.
- Able to give informed consent, and comply with study procedures.
- Normal body weight Within normal weight range (for appropriate frame) according to 1983 Metropolitan Weight tables -
Exclusion Criteria:
- Current seizure disorder, heart disease or a history of serious adverse effects due to cocaine.
- Dependence on substances (other than cocaine or nicotine) or a history of dependence on alcohol
- Request for drug treatment
- Judged to be noncompliant with study protocol.
- Current use of any psychotropic medication.
- Clinical laboratory tests outside normal limits that are clinically unacceptable to the study physician (BP > 140/90; BUN, creatinine, LFTs > 3x ULN; hematocrit < 34 for women, < 36 for men; pseudocholinesterase deficiency)
- History of myocardial infarction or ischemia, clinically significant left ventricular hypertrophy, angina, clinically significant arrhythmia, or mitral valve prolapse
- Currently meeting DSM-IV criteria for all major psychiatric/psychotic disorders other than transient psychosis due to drug abuse
- Current parole or probation Self-report during intervie -
Contacts and Locations| Contact: Nicholas Urban | 212 305 4970 |
| United States, New York | |
| Columbia University Medical Center | Recruiting |
| New York, New York, United States, 10032 | |
| Contact: Mal Zawanda 212-305-4970 | |
| Principal Investigator: Margaret Haney, Ph.D. | |
| Principal Investigator: | Margaret Haney, Ph.D. | NYS Psychiatric Institute |
More Information
No publications provided
| Responsible Party: | New York State Psychiatric Institute |
| ClinicalTrials.gov Identifier: | NCT01778010 History of Changes |
| Other Study ID Numbers: | 5738, R01DA023650 |
| Study First Received: | January 24, 2013 |
| Last Updated: | January 24, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by New York State Psychiatric Institute:
|
cocaine modafinil self-administration DRD4 |
Additional relevant MeSH terms:
|
Cocaine-Related Disorders Substance-Related Disorders Mental Disorders Cocaine Modafinil Vasoconstrictor Agents Cardiovascular Agents Therapeutic Uses Pharmacologic Actions Dopamine Uptake Inhibitors Dopamine Agents Neurotransmitter Agents |
Molecular Mechanisms of Pharmacological Action Neurotransmitter Uptake Inhibitors Physiological Effects of Drugs Anesthetics, Local Anesthetics Central Nervous System Depressants Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Central Nervous System Stimulants Neuroprotective Agents Protective Agents |
ClinicalTrials.gov processed this record on June 17, 2013