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Oxytocin Suppresses Substance Use Disorders Associated With Chronic Stress

This study is currently recruiting participants.
See Contacts and Locations
Verified April 2016 by Medical University of South Carolina
Sponsor:
Information provided by (Responsible Party):
Medical University of South Carolina
ClinicalTrials.gov Identifier:
NCT02058251
First received: February 6, 2014
Last updated: May 3, 2016
Last verified: April 2016
  Purpose
In comparison to the general population, military personnel and veterans are at increased risk of developing both substance use disorders (SUDs) and post-traumatic stress disorder (PTSD). Despite promising developments in the past decade, the treatment of patients with SUDs and comorbid PTSD is woefully inadequate (Back, 2010; Back et al., 2014; Brady et al., 2007; McCauley et al., 2012). One of the adverse effects of abused drugs is their long-term negative impact on social behavior that is thought to involve oxytocin (OT) dysregulation (McGregor et al., 2008). In preclinical and clinical experiments, local, intra-nasal, or systemic OT administration decreases activation of the amygdala in response to visual fearful/threatening stimuli (Kirsch et al., 2005), ameliorates the effects of stressful events, and decreases drug-taking and seeking behavior (McGregor et al., 2008; Baskerville and Douglas, 2010; Carson et al., 2010a; Bowen et al., 2011; Cox et al 2013). However, little attention has been focused on whether OT decreases SUD vulnerability after exposure to traumatic stress in preclinical or clinical studies. This clinical project will determine whether intra-nasally administered OT will decrease craving (Aim 1) to use alcohol and decrease stress reactivity (Aim 2) following exposure to laboratory-induced stress (Trier Social Stress Task) among veterans with a dual diagnosis of alcohol use disorder and PTSD.

Condition Intervention Phase
Alcohol Use Disorders Drug: Oxytocin Drug: Placebo Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double Blind (Participant, Investigator)
Primary Purpose: Treatment
Official Title: Oxytocin Suppresses Substance Use Disorders Associated With Chronic Stress

Resource links provided by NLM:


Further study details as provided by Medical University of South Carolina:

Primary Outcome Measures:
  • Alcohol craving [ Time Frame: 2 hours ]
    Participants will self-report ratings of subjective alcohol cravings.


Secondary Outcome Measures:
  • Stress reactivity [ Time Frame: 2 hours ]
    Participants will self-report subjective ratings of distress. Physiological measures (skin conductance, heart rate, salivary cortisol) will also be collected.


Estimated Enrollment: 66
Study Start Date: February 2014
Estimated Study Completion Date: February 2017
Estimated Primary Completion Date: January 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Oxytocin
Each participant will self-administer a 40 IU dose of intranasal oxytocin.
Drug: Oxytocin
One 40 IU dose of intranasal oxytocin will be self-administered (5 puffs in each nostril) by participants.
Placebo Comparator: Control
Each participant will self-administer a 40 IU dose of intranasal saline.
Drug: Placebo
Each participant will self-administer a 40 IU dose of intranasal saline.

  Eligibility

Ages Eligible for Study:   21 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female; any race or ethnicity; age 21-65 years.
  • Female subjects will be required to complete the laboratory testing during the early to mid-follicular phase of their menstrual cycle (days 1-7 following the onset of menses).
  • Veteran of the US military; any service branch.
  • Able to provide informed consent and function at an intellectual level sufficient to allow accurate completion of the assessment instruments.
  • Subjects must be able to comprehend English.
  • Meet DSM-5 criteria for a current alcohol use disorder (assessed via the Mini International Neuropsychiatric Interview; MINI). Note that we will use the currently available diagnostic measure (MINI for DSM-IV) and will make appropriate modifications to update for compatibility with DSM-5.
  • Meet DSM-5 criteria for current PTSD (assessed via the Clinician Administered PTSD Scale; CAPS). Note that we will use the currently available assessment instrument (CAPS for DSM-IV), and will make appropriate modifications to update for compatibility with DSM-5.
  • A CAPS score of 50 or greater.
  • Subjects will be required to have at least 5 days of abstinence from alcohol or other substances (except caffeine or nicotine) prior to completing the laboratory testing, as verified by multiple methods including self-report, breathalyzer tests, and urine drug screen tests.
  • Subjects may also meet criteria for a mood disorder (except bipolar affective disorder, see Exclusion Criteria) or anxiety disorders (e.g., agoraphobia, social phobia, generalized anxiety disorder). The inclusion of subjects with affective and anxiety disorders is essential because of the marked frequency of the co-existence of mood and other anxiety disorders among patients with PTSD and alcohol use disorders.
  • Subjects taking psychotropic medications will be required to be maintained on a stable dose for at least eight weeks before study initiation. This is because initiation or change of psychotropic medications during the course of the trial may interfere with interpretation of results.
  • Must consent to random assignment to oxytocin or placebo.

Exclusion Criteria:

  • Subjects meeting DSM-5 criteria for a history of or current psychotic or bipolar affective disorders, or with current suicidal or homicidal ideation and intent. Those subjects will be referred clinically.
  • Subjects who would present a serious suicide risk or who are likely to require hospitalization during the course of the study. Those subjects will be referred clinically.
  • Subjects on maintenance anxiolytic, antidepressant, or mood stabilizing medications, which have been initiated during the past 8 weeks.
  • Subjects with a history of a major medical illness (e.g., endocrine, cardiovascular, central nervous system disorders, peripheral neuropathy, or pulmonary disease) or other acute or unstable medical condition that might interfere with safe conduct of the study or accurate interpretation of the results.
  • Subjects meeting DSM-5 criteria for another substance use disorder, except caffeine or nicotine, within the past 12 months.
  • Subjects experiencing withdrawal symptoms, as evidence by a score of 10 or above on the Clinical Institute Withdrawal Assessment of Alcohol (CIWA)
  • Females who are unable or unwilling to be scheduled for lab testing during the early to mid-follicular phase of their menstrual cycle.
  • Pregnant women will be excluded from the proposed study.
  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: NCT02058251

Contacts
Contact: Sudie E. Back, Ph.D. 843-792-9383 backs@musc.edu
Contact: Megan Moran- Santa Maria, Ph.D. 843-792-8187 moranm@musc.edu

Locations
United States, South Carolina
Medical University of South Carolina Recruiting
Charleston, South Carolina, United States, 29425
Contact: Sudie E. Back, Ph.D.    843-792-9383    backs@musc.edu   
Sub-Investigator: Megan Moran-Santa Maria, Ph.D.         
Sub-Investigator: Julianne C. Flanagan, Ph.D.         
Sponsors and Collaborators
Medical University of South Carolina
Investigators
Principal Investigator: Sudie E. Back, Ph.D. Medical University of South Carolina
  More Information

Responsible Party: Medical University of South Carolina
ClinicalTrials.gov Identifier: NCT02058251     History of Changes
Other Study ID Numbers: 018127-002 Seq. 1
Study First Received: February 6, 2014
Last Updated: May 3, 2016

Keywords provided by Medical University of South Carolina:
Alcohol
Oxytocin
Stress reactivity

Additional relevant MeSH terms:
Disease
Substance-Related Disorders
Pathologic Processes
Chemically-Induced Disorders
Mental Disorders
Oxytocin
Oxytocics
Reproductive Control Agents
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on June 27, 2017