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Alcohol DependencePhase 2/3ATNCT00884884

Aripiprazole and Topiramate on Free-Choice Alcohol Use

A Phase 2/3 study of Alcohol Dependence, run by National Institute on Alcohol Abuse and Alcoholism (NIAAA) at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The current study investigates the effects of two potential alcohol treatment medications on drinking in a laboratory setting. Aripiprazole (APZ), effects dopamine and serotonin receptors with fewer limiting side effects seen with other atypical antipsychotics. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Alcohol Dependence
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
90 participants
Where
1 siteUnited States
Study dates
Sep 2007to Oct 2015
Phase
Phase 2/3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • must be non-treatment seeking for alcohol dependence
  • a current DSM-IV-TR diagnosis of alcohol dependence supported by the Structured Clinical Interview for DSM-IV-TR Axis I Disorders Patient Edition (SCID-I/P a minimum of ≥ 35drinks a week for men or ≥ 28 or more drinks a week for women
  • must be suitable for outpatient treatment
  • able to read English at an eighth grade level, understand their rights as provided by the informed consent, and be willing to sign an informed consent to participate in the study
  • be between 21 and 65 years on age (inclusive)
  • provide evidence of stable residence in the two months prior to enrollment and no plans to move for the next four months
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  • provide a verifiable contact person prior to randomization
  • be in generally good health as determined by the physical exam, medical history, ECG and laboratory tests
  • have a Body Mass Index >18kg/m2 and < 33 kg/m2
  • if female, must be postmenopausal practicing an effective method of birth control, have negative pregnancy tests at randomization and before the ASAE;
  • be willing to be adherent to medication dosing.

Who cannot join

  • clinically significant medical abnormalities (i.e. ECG, hematological assessment, bilirubin > 150% of the upper limit of normal or ALT or AST elevations >300% the upper limit of normal, biochemistry including urinalysis, electrolytes,). (Persons with medical conditions that are adequately controlled by their primary care physician will not be excluded.)
  • have significant alcohol withdrawal symptoms (clinical institute withdrawal assessment for alcohol revised (CIWA-Ar) >10
  • a history of suicide; history of renal impairment or nephrolithiasis; creatinine clearance of <60 dl/minute
  • pregnant or lactating or not using an adequate form of birth control
  • taking other medications that may have an effect on alcohol consumption or are carbonic anhydrase inhibitors
  • clinically significant diseases of the gastrointestinal system or active liver disease; subjects compelled to receive treatment to avoid imprisonment or loss of employment
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  • previously with a history of adverse reaction or hypersensitivity to either Topiramate or aripiprazole
  • have a diagnosis of with schizophrenia or bipolar disorder and/or taking antipsychotics and other drugs that inhibit CYP3A4 or CYP2D6 isoenzymes
  • history of seizures (e.g. epilepsy)
  • patients currently diagnosed with a substance dependence diagnosis other than alcohol or tobacco
  • patients who have participated in any clinical trial with an investigational agent within the past 30 days
  • individuals with a reasonable expectation of being institutionalized during the course of the trial or pending legal charges
  • pregnant or nursing women.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Brown University Center for Addiction Studies

    Providence, Rhode Island, 02903

Other trials in United States

About this study

The current study investigates the effects of two potential alcohol treatment medications on drinking in a laboratory setting. Aripiprazole (APZ), effects dopamine and serotonin receptors with fewer limiting side effects seen with other atypical antipsychotics. Topiramate (TPMT), an antiepileptic, affects glutamate and GABA-A receptors and shows promise in reducing heavy drinking. Few studies have used two medications with such a diverse combination of actions to examine a potential synergistic effect on reducing alcohol consumption.

The primary aims are to:

  1. determine if APZ and TPMT are each more effective than placebo, and the combination of APZ and TPMT is more effective than either drug alone or placebo, in reducing alcohol use in non-treatment seeking alcohol dependent subjects in a laboratory based alcohol self-administration experiment (ASAE)
  2. examine a hypothesized dose-response for three doses of APZ (0, 7.5 mg/d and 15 mg/d) along with three doses of TPMT (0, 100mg/d and 200mg/d)
  3. examine the putative mechanisms of action of APZ, TPMT alone and together on craving, subjective stimulation, candidate gene influences and other behavioral effects associated with alcohol consumption
  4. establish the safety of giving APZ and TPMT together. Non-treatment seeking, alcohol dependent Participants (N=216) will be recruited from the community and randomly assigned to one of the 9 cells. Subjects drinking and safety is monitored over a 5-week titration to their target dose, leading to an in-laboratory alcohol self administration session, during which clinical and behavioral effects are assessed during access to alcohol. A 1 month follow-up assesses adverse events and drinking.
Read the detailed description

Due to the modest effect of current pharmacotherapies, more effective treatments must be developed to optimally treat alcohol dependent patients. Treatments combining pharmacotherapies with different mechanisms of action may better address the diverse neurobiology of alcohol and the heterogeneity of alcoholics. However, little is known about how medication may affect behavior to reduce drinking. Aripiprazole (APZ), a partial dopamine agonist, affects dopamine and serotonin receptors without the limiting side effects seen with other atypical antipsychotics. Dopamine mediates reward based drinking and craving. Topiramate (TPMT), an antiepileptic, affects glutamate and GABA-A receptors and shows promise in reducing heavy drinking. Glutamate and GABA may mediate relief-based drinking and protracted withdrawal. Despite strong evidence that multiple neurotransmitters contribute to alcoholism, few studies have used two medications with such a diverse combination of actions to examine a potential synergistic effect on reducing alcohol consumption.

The present study will recruit 216 healthy, alcohol-dependent volunteers who are not currently seeking treatment for their alcohol dependence to learn more about how these medications may work.

The primary aims are to: (1) determine if APZ and TPMT are each more effective than placebo, and the combination of APZ and TPMT is more effective than either drug alone or placebo, in reducing alcohol use in non-treatment seeking alcohol dependent subjects in an alcohol self administration experiment (ASAE); (2) examine a hypothesized dose-response for three doses of APZ (0, 7.5mg/d and 15 mg/d) and three doses of TPMT (0, 100mg/d, 200mg/d); (3) examine the putative mechanisms of action of APZ, TPMT alone and together on craving, subjective stimulation, candidate gene influences and other behavioral effects associated with alcohol consumption; and (4) establish the safety of giving APZ and TPMT together. We will use of a 3 X 3 drug (7.5mg, 15mg APZ vs. placebo) by drug (100mg, 200mg TPMT vs. placebo) between-subjects factorial design. Participants are randomly assigned to one of 9 cells. Subjects drinking and safety is monitored over a 5-week titration to their target dose, leading to an in-laboratory alcohol self administration session, during which clinical and behavioral effects are assessed during access to alcohol. A 1 month follow-up assesses adverse events and drinking. The long term objectives of this research are to improve medications available for alcoholism treatment and inform research and theory on the mechanisms of action of such medications.

Being tested
Double Placebo, Aripiprazole 15, placebo, Aripiprazole 7.5, Placebo, Topiramate 100, Placebo, Topiramate 200, Placebo
Keywords
Alcohol dependence, alcohol abuse, topiramate, aripiprazole
Medical subject headings
Alcoholism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Double PlaceboDrug

    1 capsule daily

  • Aripiprazole 15, placeboDrug

    Also called Abilify, Topamax

    15 mg Aripiprazole daily plus placebo daily

  • Aripiprazole 7.5, PlaceboDrug

    Aripiprazole 7.5 mg daily plus Placebo daily

  • Topiramate 100, PlaceboDrug

    Topiramate 100 mg daily plus Placebo daily

  • Topiramate 200, PlaceboDrug

    Topiramate 200 mg daily plus Placebo daily

  • Topiramate 100, Aripiprazole 15Drug

    Also called Abilify, Topamax

    Topiramate 100 mg daily plus Aripiprazole 15mg daily

  • Topiramate 100, Aripiprazole 7.5Drug

    Topiramate 100 mg daily plus Aripiprazole 7.5mg daily

  • Topiramate 100, Aripiprazole 15mgDrug

    Also called Abilify, Topamax

    Topiramate 100 mg daily plus Aripiprazole 15mg daily

  • Topiramate 200, Aripiprazole 7.5mgDrug

    Also called Abilify, Topamax

    Topiramate 200 mg daily plus Aripiprazole 7.5mg daily

  • Topiramate 200, Aripiprazole 15Drug

    Also called Abilify, Topamax

    Topiramate 200mg daily plus Aripiprazole 15mg daily

Study groups in NCT00884884
Study groupRoleWhat they receive
Double PlaceboPlacebo comparatorPlacebo, Placebo
Receives: Drug: Double Placebo
Aripiprazole 15, PlaceboExperimental15 mg Aripiprazole, Placebo
Receives: Drug: Aripiprazole 15, placebo
Aripiprazole 7.5, PlaceboExperimentalAripiprazole 7.5 mg daily plus Placebo daily
Receives: Drug: Aripiprazole 7.5, Placebo
Topiramate 100mg, PlaceboExperimentalTopiramate 100 mg daily plus Placebo daily
Receives: Drug: Topiramate 100, Placebo
Topiramate 200, PlaceboExperimentalTopiramate 200 mg daily plus Placebo daily
Receives: Drug: Topiramate 200, Placebo
Topiramate 100, Aripiprazole 5ExperimentalTopiramate 100 daily plus, Aripiprazole 5mg daily
Receives: Drug: Topiramate 100, Aripiprazole 15; Drug: Topiramate 100, Aripiprazole 15mg
Topiramate 200, Aripiprazole 15ExperimentalTopiramate 200 mg daily plus Aripiprazole 15mg daily
Receives: Drug: Topiramate 200, Aripiprazole 15
Topiramate 100, Aripiprazole 7.5ExperimentalTopiramate 100 mg daily, Aripiprazole 7.5 mg daily
Receives: Drug: Topiramate 100, Aripiprazole 7.5
Topiramate 200, Aripiprazole 7.5mgExperimentalTopiramate 200 mg daily plus Aripiprazole 7.5mg daily
Receives: Drug: Topiramate 200, Aripiprazole 7.5mg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of alcoholic drinks consumed in a laboratory setting

    Measured: 90 minutes

  2. Safety and tolerability of the medications singly and in combination, compared to placebo

    Measured: 4 years

Secondary outcomes (1)
  1. Drinks consumed during the medication titration period

    Measured: 4 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Apr 2009 (estimated)
  2. Study startSep 2007
  3. Primary completionOct 2015
  4. Study completionOct 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
90 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00884884
Sponsor's protocol ID
NIAAA-Swift-AA015753
Other IDs
NIH Grant 5RO1AA015753-02
Acronym
AT
Status last verified
Oct 2015
First submitted
20 Apr 2009
Last updated
7 Oct 2015
Results posted
No
Data monitoring committee
No

Publications

  • Haass-Koffler CL, Goodyear K, Zywiak WH, Leggio L, Kenna GA, Swift RM. Comparing and Combining Topiramate and Aripiprazole on Alcohol-Related Outcomes in a Human Laboratory Study. Alcohol Alcohol. 2018 May 1;53(3):268-276. doi: 10.1093/alcalc/agx108.

    PubMed 29281033

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study of Alcohol Dependence, run by National Institute on Alcohol Abuse and Alcoholism (NIAAA) at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Oct 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of alcoholic drinks consumed in a laboratory setting (time frame: 90 minutes). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00884884, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Oct 2015.

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