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Atomoxetine for Treating Cocaine Abuse in Adults With Attention Deficit Hyperactivity Disorder (ADHD) (Atom)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00218543
Recruitment Status : Completed
First Posted : September 22, 2005
Results First Posted : July 4, 2012
Last Update Posted : April 24, 2019
National Institute on Drug Abuse (NIDA)
Information provided by (Responsible Party):
Frances R Levin, New York State Psychiatric Institute

Brief Summary:
Studies have shown that individuals with attention deficit hyperactivity disorder (ADHD) are at greater risk for having a substance use disorder compared to people who do not have ADHD. Rates of cocaine abuse in adults with ADHD are significantly higher than they are in adults who do not have ADHD. Some clinicians suggest that adults with ADHD may abuse cocaine in order to self-medicate their ADHD symptoms. Atomoxetine is a drug that has been effective in treating ADHD. This study will evaluate the effectiveness of atomoxetine in reducing cocaine use in people with ADHD who abuse cocaine.

Condition or disease Intervention/treatment Phase
Attention Deficit Disorder With Hyperactivity Cocaine-Related Disorders Drug: Atomoxetine Phase 2

Detailed Description:

ADHD is a neurologic disorder that is thought to be caused by chemical imbalances of certain neurotransmitters in the brain. The disorder can cause inattention, hyperactivity, and impulsivity. Cocaine abuse rates in adults with ADHD are significantly higher than they are in adults who do not have the disorder. This may be reflective of an attempt by individuals with ADHD to self-treat symptoms. Atomoxetine is an FDA-approved drug that is used to increase the ability to pay attention and decrease impulsiveness and hyperactivity in children and adults with ADHD. The drug is in a class of medications called selective norepinephrine reuptake inhibitors and works by increasing the levels of norepinephrine, a natural substance in the brain that affects a person's attention and impulsivity. It is possible that reducing ADHD symptoms in cocaine abusers with ADHD will help decrease their need for cocaine. This study will evaluate the effectiveness of atomoxetine in reducing cocaine use in people with ADHD who abuse cocaine.

Participants in this open label study will receive atomoxetine for 12 weeks, and will take one dose each morning for the duration of the study. Doses will be increased gradually to minimize side effects and enhance treatment compliance. In addition, all participants will receive individualized relapse prevention therapy once weekly. Participants will be required to report to the study site three times a week to receive medication, complete questionnaires regarding ADHD symptoms and substance use behavior, and provide a urine sample while being supervised by study staff. Also, vital signs will be monitored and medication side effects will be assessed at each visit. Participants will report to the study site 6 months after starting in the study for a follow-up visit, at which time ADHD symptoms, substance use behavior, and social functioning will be assessed.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 20 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Atomoxetine Treatment for Cocaine Abuse and Adult Attention-Deficit Hyperactivity Disorder (ADHD): A Preliminary Open Trial
Study Start Date : June 2004
Actual Primary Completion Date : March 2007
Actual Study Completion Date : March 2007

Arm Intervention/treatment
Experimental: Atomoxetine
Drug: Atomoxetine
At the start of week 7, patients will be maintained at 80 mg/day or increased to the maximal dose of 100 mg/day if less than a 50% reduction of symptoms on the ADHD Rating Scale occurs, and if the patient is tolerating the medication well.

Primary Outcome Measures :
  1. the Adult ADHD Rating Scale (AARS) (30% Reduction) [ Time Frame: baseline compared to rating at week 12 or last rating during study participation ]
    AARS is a self report that measures symptoms of adult ADHD. The primary outcome was the percentage of patients achieving a 30% reduction from baseline on the AARS scale. The AARS is scored on a continuous, range 0-54. 0 being no symptoms and 54 being indicative of the most severe level of symptoms.

  2. ADHD Symptoms Based on Adult ADHD Rating Scale Scale (AARS) [ Time Frame: measured during 12 weeks or length of study participation ]
    Weekly AARS scores (continuous, range 0-54) were examined with the baseline score compared to that at the last assessment obtained and change in these scores over time. The AARS looks at adult ADHD symptoms. A score of 0 represents no symptoms and 54 would be indicative of the most severe level of symptoms.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Meets DSM-IV criteria for cocaine dependence and adult ADHD
  • Describes cocaine as the primary drug of abuse
  • Meets DSM-IV criteria for cocaine dependence

Exclusion Criteria:

  • Meets DSM-IV criteria for current Axis I psychiatric disorders that require a psychiatric intervention (except ADHD or substance abuse)
  • Current major depression
  • Unstable physical disorders that might make participation unsafe (e.g., uncontrolled high blood pressure and tachycardia [systolic blood pressure greater than 150 mm Hg, diastolic blood pressure greater than 90 mm Hg, or a sitting heart rate greater than 100])
  • Acute hepatitis (individuals with chronic mildly elevated transaminase levels of less than 2 or 3 times the normal limit are not excluded)
  • Diabetes
  • Coronary vascular disease, as indicated by a history or suspected by an abnormal electrocardiogram
  • History of cardiac symptoms
  • History of seizures
  • Narrow angle glaucoma
  • Use of monoamine oxidase inhibitors (MAOIs) within 2 weeks of starting treatment with atomoxetine
  • Currently taking prescribed psychotropic medications
  • Currently taking medications for the treatment of ADHD
  • Known sensitivity to atomoxetine
  • Current suicidal ideation or history of suicidal or homicidal behavior within 2 years prior to study entry
  • Pregnant or breastfeeding
  • Physiologically dependent on any drugs other than nicotine or marijuana
  • History of schizophrenia, bipolar disorder, or other psychotic disorders
  • Currently taking cough medicine (e.g., dextromethorphan) and/or albuterol

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00218543

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United States, New York
Research Foundation for Mental Hygiene, Inc.
New York, New York, United States, 10032
Sponsors and Collaborators
New York State Psychiatric Institute
National Institute on Drug Abuse (NIDA)
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Principal Investigator: Herbert Kleber, MD New York State Psychiatric Institute
Additional Information:
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Responsible Party: Frances R Levin, Director of Substance Use Disorder, New York State Psychiatric Institute Identifier: NCT00218543    
Other Study ID Numbers: #4611
P50DA009236 ( U.S. NIH Grant/Contract )
First Posted: September 22, 2005    Key Record Dates
Results First Posted: July 4, 2012
Last Update Posted: April 24, 2019
Last Verified: April 2019
Keywords provided by Frances R Levin, New York State Psychiatric Institute:
Cocaine Abuse
Additional relevant MeSH terms:
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Cocaine-Related Disorders
Attention Deficit Disorder with Hyperactivity
Pathologic Processes
Attention Deficit and Disruptive Behavior Disorders
Neurodevelopmental Disorders
Mental Disorders
Neurologic Manifestations
Nervous System Diseases
Substance-Related Disorders
Chemically-Induced Disorders
Atomoxetine Hydrochloride
Adrenergic Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Adrenergic Agents
Neurotransmitter Agents
Physiological Effects of Drugs