Quetiapine for Bipolar Disorder and Alcohol Dependence

• ClinicalTrials.gov Identifier: NCT00457197
• Recruitment Status: Completed
• First Posted: April 6, 2007
• Results First Posted: January 28, 2016
• Last Update Posted: April 5, 2016
• Sponsor: University of Texas Southwestern Medical Center
• Information provided by (Responsible Party): University of Texas Southwestern Medical Center

Study Description

Brief Summary:

The purpose of this study is to find out whether an investigational drug called quetiapine can treat bipolar disorder, improve mood and reduce alcohol use and craving.

Condition or disease	Intervention/treatment	Phase
Bipolar Disorder; Alcohol Dependence	Drug: Placebo; Drug: Quetiapine	Phase 4

Detailed Description:

The primary aim in the study is to determine if quetiapine treatment is associated with greater reduction in alcohol use than placebo in outpatients with bipolar disorder and alcohol dependence. We will also examine if quetiapine treatment is associated with greater reduction in alcohol craving than placebo in outpatients with bipolar disorder and alcohol dependence and if quetiapine treatment is associated with greater improvement in depressive symptoms than placebo in outpatients with bipolar disorder and alcohol dependence.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 90 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: Quetiapine for Bipolar Disorder and Alcohol Dependence
• Study Start Date: March 2007
• Actual Primary Completion Date: July 2011
• Actual Study Completion Date: July 2011

Arms and Interventions

Arm	Intervention/treatment
Placebo Comparator: Placebo; This group will be given placebo matching quetiapine for the course of the 12 weeks in the study.	Drug: Placebo; Inactive ingredient matching the active medication in appearance.; Other Name: Sugar-pill
Active Comparator: Quetiapine; This group will be given 50mg Quetiapine per day baseline-week 1, 100mg Quetiapine per day week 1-week 2, 200mg Quetiapine per day week 2-week 3, 400mg Quetiapine per day week 3-week 4, and 600mg Quetiapine per day week 4 to week 12.	Drug: Quetiapine; Quetiapine is an atypical antipsychotic approved for the treatment of schizophrenia, bipolar disorder, and in the XR version along with an SSRI to treat major depressive disorder.; Other Names: Seroquel; Xeroquel; Ketipinor

Outcome Measures

Primary Outcome Measures :

1. The Number of Standard Drinks/Day Will Serve as the Primary Outcome Measure. [ Time Frame: 12 weeks ]

Secondary Outcome Measures :

1. Percent of Heavy Drinking Days [ Time Frame: 12 weeks ]
2. Gamma-glutamyltransferase (GGT) [ Time Frame: 12 weeks ]
   GGT is a liver enzyme measurement (IU/I)
3. Aspartate Aminotransferase (AST) [ Time Frame: 12 weeks ]
   AST is a liver enzyme measurement (IU/I)
4. Alanine Aminotransferase (ALT) [ Time Frame: 12 weeks ]
   ALT is a liver enzyme measurement (IU/I).
5. Hamilton Rating Scale for Depression (HRSD) [ Time Frame: 12 weeks ]

   The assessment is a clinician administered rating of depression with 17 questions. The total score is indicates level of depression within the following ranges: none (0-5), mild (6-10), moderate (11-15), severe (16-20), and very severe (21+).

   Scale:

   Minimum: 0 Maximum: 50 Lower score associated with better outcome

6. Inventory of Depressive Symptomatology-Self Report (IDS-SR) [ Time Frame: 12 weeks ]

   IDS-SR is a self reported 30 item assessment to diagnose a major depressive episode.

   Score:

   Minimum: 0 Maximum: 84 Lower score associated with better outcome

7. Young Mania Rating Scale (YMRS) [ Time Frame: 12 weeks ]

   This is an 11-item, observer rated measure of the severity of manic symptoms on a 5 point scale. The total score indicates overall severity of mania with a minimum of zero (indicating normalcy) and a maximum of 60 (indicating very severe).

   Score:

   Minimum: 0 Maximum: 60 Lower score associated with better outcome

8. Penn Alcohol Craving Scale (PACS) [ Time Frame: 12 weeks ]

   The PACS is a five-item self-administered instrument for assessing craving, frequency, intensity, and duration of thoughts about drinking are assessed along with ability to resist drinking

   Score:

   Minimum: 0 Maximum: 30 Lower score associated with better outcome.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 65 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Outpatients with a diagnosis of bipolar I or II disorder, depressed or mixed phase on the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders (SCID) and confirmed by interview with PI or co-I.
• Current diagnosis of alcohol dependence.
• Alcohol use (by self-report) of at least 15 drinks in the 7 days prior to baseline.
• Currently taking a mood stabilizer defined as lithium, divalproex/valproic acid, oxcarbazepine, or lamotrigine at a stable dose for > 14 days.
• Men and women age 18-65 years old.
• English or Spanish speaking.

Exclusion Criteria:

• Bipolar disorders other than bipolar I or II (e.g., not otherwise specified or cyclothymic disorders) based on the SCID and confirmed through clinical assessment by PI or co-I.
• Baseline Young Mania Rating Scale (YMRS) score > 35 or Hamilton Depression Rating Scale (HRSD) 17 score > 35.
• Current clinically significant psychotic features (hallucinations, delusions, disorganized thought processes).
• Evidence of clinically significant alcohol withdrawal symptoms defined as a Clinical Institute Withdrawal Assessment (CIWA-AR) score of > 8.
• History of hepatic cirrhosis or baseline AST or ALT > 3X upper limit of normal or other clinically significant findings on physical or laboratory examination.
• Mental retardation or other severe cognitive impairment.
• Prison or jail inmates.
• Pregnant or nursing women or women of childbearing age who will not use oral contraceptives, abstinence, or other acceptable methods of birth control during the study.
• Antipsychotic therapy within 14 days prior to randomization.
• Current carbamazepine or benzodiazepine therapy.
• Current treatment with medications shown to reduce alcohol consumption (naltrexone, acamprosate, disulfiram, or topiramate) in large randomized, controlled trials.
• Initiation of antidepressants or mood stabilizers or psychotherapy within past 2 weeks.
• High risk for suicide, defined as any suicide attempts in the past 3 months or current suicidal ideation with plan and intent.
• Intensive outpatient treatment for substance abuse (AA, NA meetings, or other 12-step programs or weekly psychotherapy that started at least 14 days prior to randomization will be allowed).
• Current treatment with ketoconazole, itraconazole, erythromycin, or nefazodone.
• Severe or life-threatening medical condition (e.g., congestive heart failure, terminal cancer) or laboratory or physical examination findings consistent with serious medical illness (e.g., severe edema, atrial fibrillation, dangerously abnormal electrolytes).
• Diabetes mellitus by history or suspected from baseline blood sugar.
• History of cataracts or suspected cataracts on ophthalmic exam
• History of seizure disorder of any etiology; if a subject develops a seizure episode, s/he will be discontinued from the study.

Contacts and Locations

Locations

United States, Texas

Psychoneuroendocrine Research Program

Dallas, Texas, United States, 75235

Sponsors and Collaborators

University of Texas Southwestern Medical Center

Investigators

• Principal Investigator: E. Sherwood Brown, MD PhD; UT Southwestern Medical Center

More Information

• Responsible Party: University of Texas Southwestern Medical Center
• ClinicalTrials.gov Identifier: NCT00457197
• Other Study ID Numbers: 112006-046
• First Posted: April 6, 2007
• Results First Posted: January 28, 2016
• Last Update Posted: April 5, 2016
• Last Verified: April 2016

Keywords provided by University of Texas Southwestern Medical Center:

bipolar disorder; alcohol dependence; mania; manic disorder; depression

Additional relevant MeSH terms:

Disease; Alcoholism; Bipolar Disorder; Pathologic Processes; Bipolar and Related Disorders; Mental Disorders; Alcohol-Related Disorders; Substance-Related Disorders; Chemically-Induced Disorders; Quetiapine Fumarate; Antidepressive Agents; Psychotropic Drugs; Antipsychotic Agents; Tranquilizing Agents; Central Nervous System Depressants; Physiological Effects of Drugs