- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00571103
Acamprosate in the Treatment of Pathological Gambling
April 24, 2017 updated by: Donald Black, University of Iowa
Open Label, Flexible Dose 12-Week Clinical Trial of the Safety and Efficacy of Acamprosate in the Treatment of Pathological Gambling
The purpose of this study is to see whether acamprosate (Campral) will curb the desire to gamble in people with pathological gambling disorder.
Study Overview
Detailed Description
Because the opiate antagonists appear to be effective in the treatment of pathological gambling (PG), it is reasonable to ask whether acamprosate (calcium acetylhomotaurine; Campral), also FDA approved for the treatment of alcoholism, can be used effectively to treat PG.
Acamprosate is not an opioid antagonist; rather, it is assumed that its therapeutic effects are due to actions on GABA receptors.
Acamprosate is structurally related to 1-glutamic, which is an excitatory neurotransmitter.
It has been proposed that acamprosate decreases the effects of the naturally-occuring excitatory neurotransmitter glutamate in the body.
Because chronic alcohol consumption disrupts this system, and the changes last many months after alcohol ingestion is stopped, it is possible that acamprosate restores the glutamate system towards normal.
Regardless, acamprosate decreases the pleasant "high" associated with alcohol consumption, and thus decreases the frequency of relapse during abstinence.
We hypothesize that acamprosate will have similar actions in persons with PG.
Study Type
Interventional
Enrollment (Actual)
26
Phase
- Phase 4
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
Ages Eligible for Study
18 years to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients will meet DSM-IV (Diagnostic and Statistical Manual 4th Edition) criteria for Pathological Gambling Disorder
- Patients will achieve a SOGS (South Oaks Gambling Screen) score greater than or equal to 5
- Patients will be 18 years old or older
- Patients will speak standard English
- Patients will be able to give written Informed Consent
- Patients will be able to understand and cooperate with study procedures
Exclusion Criteria:
- Patients having a current (past 3 months) substance use disorder (except dependence)
- Patients having a Hamilton Depression Rating score of greater than or equal to 18 or a score on #1 (depressed mood) greater than 1.
- Patients having a clinically significant medical illness
- Patients at risk for aggressive or suicidal behavior
- Patients who have received the following interventions within the proscribed time prior to study entry: 1) a monoamine oxidase inhibitor within the previous 21 days; 2) long-acting phenothiazines within the previous 3 months; 3) other psychotropic drugs within the previous 14 days; 4) flu- oxetine within the previous 4 weeks.
- Patients having severe antisocial or borderline personality disorder
- Patients with a past or current diagnosis of schizophrenia, schizoaffective disorder, psychotic disorder, bipolar disorder, or delirium, dementia, or other clinically significant cognitive disorder.
- Patients initiating individual, group, or couple psychotherapy during the three moths prior to study entry (excluding Gambler's Anonymous)
- Patients having prior exposure to acamprosate
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: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1 Open Label
Open Label.
At visit 2, all participants were started on Acamprosate, 1,998 mg divided into 3 equal doses.
|
Two 333mg tablets taken three times daily.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Primary Efficacy Measure Was the Yale-Brown Obsessive Compulsive Scale Modified for PG (YBOCS-PG).
Time Frame: 8 weeks minus baseline
|
The YBOCS-PG (Yale Brown Obsessive Compulsive Scale modified for Pathological Gambling) is used to assess the range and severity of PG symptoms.
The scale is a modification of the YBOCS originally developed by Goodman et al. (1989) for use in rating severity and change in subjects with Obsessive Compulsive Disorder.
This adaptation is a 10-item clinician-rated questionnaire, which rates (on a 5-point scale from 0 to 4) time spent, distress, interference, resistance, and control in relation to PG urges and behaviors.
The scale ranges from 0 to 40 with a higher score representing increased severity in PG.
|
8 weeks minus baseline
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Secondary Efficacy Evaluations Will Include the G-SAS (Gambling Symptom Assessment Scale), Clinical Global Impression - Improvement Scale (CGI-I) , and the CGI-S Clinical Global Impression - Severity Scale.
Time Frame: 8 weeks minus baseline
|
The G-SAS is a 12 item self-report instrument that reflects the subjects urges to gamble and the subjects gambling behavior.
Each item is scored on a 5-point scale from 0 (no symptoms) to 4 (extreme symptoms) with a total score range from 0 to 48.
The CGI-I is a 7 point scale requiring the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.
The CGI-S is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment.
A patient is assessed on severity of mental illness at the time of rating 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; and 7, among the most extremely ill patients.
|
8 weeks minus baseline
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Donald W Black, MD, The University of Iowa Carver College of Medicine
- Principal Investigator: Dennis P McNeilly, PsyD, University of Nebraska
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
October 1, 2007
Primary Completion (Actual)
July 1, 2009
Study Completion (Actual)
July 1, 2009
Study Registration Dates
First Submitted
December 10, 2007
First Submitted That Met QC Criteria
December 10, 2007
First Posted (Estimate)
December 11, 2007
Study Record Updates
Last Update Posted (Actual)
May 25, 2017
Last Update Submitted That Met QC Criteria
April 24, 2017
Last Verified
April 1, 2017
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 200608747
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
IPD Plan Description
We do not plan to share individual participant data.
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.
Clinical Trials on Pathological Gambling
-
Université Catholique de LouvainCentre Hospitalier Universitaire Vaudois; Cliniques universitaires Saint-Luc-... and other collaboratorsUnknownCraving | Gambling | Gambling Disorder | Gambling, Pathological | Gambling ProblemSwitzerland
-
University of WashingtonNational Institute of Mental Health (NIMH)CompletedGambling | Pathological Gambling | Problem GamblingUnited States
-
University of ChicagoCompleted
-
ITAB - Institute for Advanced Biomedical TechnologiesNot yet recruitingAccelerated rTMS in Gambling Disorder: a Multicentric, Randomized, Sham-controlled Trial (arTMSinGD)Gambling | Gambling Disorder | Gambling, Pathological | Gambling Problem
-
Finnish Institute for Health and WelfareUnknownNaloxone | Gambling Disorder | Opioid Antagonist | Pathological GamblingFinland
-
University of California, San FranciscoNational Center for Responsible GamingCompletedPathological Gambling
-
Universitätsklinikum Hamburg-EppendorfCompletedGambling, PathologicalGermany
-
University of IowaNational Institute of Mental Health (NIMH)Completed
-
Kurihama Medical and Addiction CenterUnknownPathological GamblingJapan
-
Finnish Institute for Health and WelfareCompletedPathological GamblingFinland
Clinical Trials on acamprosate
-
Mayo ClinicSamuel C. Johnson FoundationCompleted
-
University of New MexicoWithdrawnSafety of Acamprosate for Alcohol Dependence in the Elderly: An Open-Label Study (SAFADIE) (SAFADIE)Alcohol DependenceUnited States
-
Baylor College of MedicineNational Parkinson FoundationWithdrawnParkinson's DiseaseUnited States
-
Yale UniversityNational Institute on Alcohol Abuse and Alcoholism (NIAAA)Completed
-
University of North Carolina, Chapel HillUniversity of Wisconsin, MilwaukeeCompletedAlcohol DependenceUnited States
-
Children's Hospital Medical Center, CincinnatiRush University Medical CenterCompleted
-
Lindner Center of HOPEForest Laboratories; University of CincinnatiCompleted
-
University of PennsylvaniaNational Institute on Drug Abuse (NIDA)CompletedCocaine DependenceUnited States
-
Synchroneuron Inc.WithdrawnTourette SyndromeUnited States
-
National Institutes of Health Clinical Center (CC)National Institute on Alcohol Abuse and Alcoholism (NIAAA)CompletedAlcohol Dependence | Alcoholism | Alcohol-Related Disorders | Healthy VolunteerUnited States