Behavioral and Physiological Effects of Cocaine in Cocaine-dependent Participants Treated With Levodopa in Combination With Carbidopa and Entacapone (LCE) (COST)

May 17, 2018 updated by: Adam Bisaga, New York State Psychiatric Institute
An inpatient safety study to characterize the cardiovascular and behavioral effects of cocaine administration in the presence of LCE. The proposed study involves an inpatient stay of 12 days during which participants will have two cocaine-administration sessions, each including five doses of smoked cocaine with ascending doses.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Cocaine dependence remains a serious public health problem; however no clearly effective pharmacological treatments have been identified to date. We hypothesize that identification of subgroups of cocaine-dependent patients will help to develop targeted and more effective treatments. We hypothesize that individuals who have difficulties in achieving abstinence have a deficit in dopaminergic functioning and correcting this deficit using dopaminergic medication levodopa in combination with carbidopa and entacapone (LCE) to increase availability and uptake of levodopa to synthesize dopamine in the brain will result in clinical improvement. We were unable to locate any clinical reports that might provide data on the interaction between cocaine and LCE. Therefore, we would like to conduct an inpatient safety study to characterize the cardiovascular and behavioral effects of cocaine administration in the presence of LCE. The proposed study involves an inpatient stay of 12 days during which participants will have two cocaine-administration sessions, each including five doses of smoked cocaine with ascending doses. Participants will be maintained on placebo capsules prior to the first study session and on the LCE prior to the second session. Physiological (HR, BP, ECG) as well as behavioral (subjective effects) effects of cocaine will be monitored during cocaine-administration sessions. Serial blood samples will also follow cocaine administration to assess whether the pharmacokinetics of cocaine is altered during treatment with LCE. All participants will also undergo two cognitive testing sessions, one on placebo and one on LCE, employing a computerized battery (Quarters, Gambling task, Drug Stroop, Threat Responsivity task). There will be an optional functional MRI (fMRI) component that will investigate behavioral and neural indicators of reward responsivity, thought to reflect dopaminergic transmission. Participants choosing to undergo fMRI testing will complete two sessions, on the same days as the cognitive task sessions. Data obtained in the present study will be used to inform the large, controlled trial of LCE in treatment seeking cocaine-dependent individuals.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
15

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New York
      • New York, New York, United States, 10032
        • New York State Psychiatric Institute

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

21 years to 50 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Adult, age 21-50.
  • Smokes cocaine on average at least 1x/week; currently spends at least $30/week on cocaine. Has been using cocaine for at least 6 months Urine toxicology positive for cocaine metabolites
  • Has patterns of smoked cocaine use in terms of frequency and amount that parallels or exceed those administered in the study
  • Able to give informed consent and comply with study procedures

Exclusion Criteria:

  • Current DSM-IV criteria of substance use disorders with the exception of cocaine or nicotine dependence, or a history of alcohol or cannabis dependence.
  • Request for drug treatment
  • Unstable medical disorders, or medical disorders that might interfere with study participation, including current seizure disorder, heart disease or a history of serious adverse effects due to cocaine.
  • Judged to be noncompliant with study protocol
  • Concurrent use of any psychotropic medications
  • Concurrent use of MAO inhibitors or epinephrine (patients must be off MAOIs for a minimum of 2 weeks)
  • Clinical laboratory tests outside normal limits that are clinically unacceptable to the study physician (systolic BP > 140 and < 90, diastolic BP > 90 and < 60, and heart rate > 90; BUN, creatinine, LFTs > ULN; hematocrit < 34 for women, < 36 for men; pseudocholinesterase deficiency)
  • Positive serum pregnancy test, lactation, or unwillingness to use a satisfactory method of birth control
  • History of myocardial infarction or ischemia, clinically significant left ventricular hypertrophy, angina, clinically significant arrhythmia, or mitral valve prolapse
  • History of narrow angle glaucoma or prostate cancer
  • History of melanoma or current suspicious undiagnosed skin lesions
  • Currently meeting DSM-IV criteria for all major psychiatric/psychotic disorders other than transient psychosis due to drug abuse
  • History of allergic reaction or adverse reaction to study medications (levodopa/carbidopa/entacapone).
  • Current parole or probation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Experimental
L-dopa / carbidopa / entacapone (LCE)
Drug: L-dopa / carbidopa / entacapone (LCE)
For this trial we propose a target dosage of L-dopa / carbidopa / entacapone of 400 mg L-dopa / 100mg carbidopa / 200 mg entacapone, twice daily.
Other Names:
  • L/C/E

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Blood pressure
Time Frame: (baseline) prior to and after each of the 6 cocaine administrations at 4, 18, 32, 46, 60, 74, 104 and 134 minutes after the first dose
Maximum SBP, maximum DPB will be obtained at baseline, prior to the first session dose, and after each consecutive dose (0, 6, 12, 25, 50, 50 mg). Changes from baseline in blood pressure in the used by cocaine administration under placebo condition will be compared to those obtained during treatment with LCE using repeated measures ANOVA.
(baseline) prior to and after each of the 6 cocaine administrations at 4, 18, 32, 46, 60, 74, 104 and 134 minutes after the first dose
heart rate
Time Frame: (baseline) prior to and after each of the 6 cocaine administrations at 4, 18, 32, 46, 60, 74, 104 and 134 minutes after the first dose
Heart rate will be obtained at baseline, prior to the first session dose, and after each consecutive dose (0, 6, 12, 25, 50, 50mg). Changes from baseline in heart rate in the used by cocaine administration under placebo condition will be compared to those obtained during treatment with LCE using repeated measures ANOVA.
(baseline) prior to and after each of the 6 cocaine administrations at 4, 18, 32, 46, 60, 74, 104 and 134 minutes after the first dose

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Composite (or Profile) of Pharmacokinetics
Time Frame: 18, 32, 46, 60, 74, 104 minutes post dose
Cmax, Area Under Curve, Tmax
18, 32, 46, 60, 74, 104 minutes post dose
subjective cocaine experience
Time Frame: Done at baseline and at 4, 18, 32, 46, 60, 74, 104 and 134 minutes after the first dose
1) An assessment of the subjective cocaine experience with and without study medication using a standard battery of 100 mm visual analog scales (VAS) that will be administered pre-dosing and after each dose. Each VAS item will be summarized using AUC, mean and peak scores collected for all time points and analyzed using ANOVA with corrections for multiple comparisons.
Done at baseline and at 4, 18, 32, 46, 60, 74, 104 and 134 minutes after the first dose

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
New York State Psychiatric Institute

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
National Institute on Drug Abuse (NIDA)
Columbia University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Adam Bisaga, M.D., Columbia University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 1, 2010

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 1, 2012

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 1, 2012

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 18, 2010

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 19, 2011

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 20, 2011

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
May 21, 2018

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 17, 2018

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • #6141 P50 DA 009236-16
  • P50DA009236 (U.S. NIH Grant/Contract)
  • P50DA009236-16 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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