- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01437046
Doxazosin an a1 Antagonist for Alcohol Dependence
July 20, 2015 updated by: George Kenna, Brown University
Only three medications are approved by the Food and Drug Administration (FDA) for the treatment of alcohol dependence (AD), namely disulfiram, naltrexone tablets and injection, and acamprosate, however treatment success has been inconsistent.
Thus, there exists a substantial need for discovering ways to provide more effective treatments.
Pre-clinical and clinical evidence has clearly demonstrated that the noradrenergic (NE) system is involved in the neurobiology of AD, thus representing an interesting new pharmacotherapy target and the theoretical rationale for this proposal.
Consistent with the concept that the NE system may represent a new pharmacological target for AD, recent studies have shown that the prototype alpha-1 NE receptor antagonist prazosin reduces alcohol drinking in different animal models.
Furthermore, clinical evidence has also confirmed that prazosin appears to be efficacious in reducing alcohol consumption in alcohol-dependent individuals.
While prazosin has a significant side effect profile and must be taken three times a day, no other α1-blockers have been investigated in alcohol research.
Prazosin is a short-acting α1-blocker approved to treat hypertension (HTN) and benign prostatic hyperplasia (BPH).
After the approval of prazosin in the 70's, other selective α1-blockers have been developed to treat HTN and/or BPH.
Among them, doxazosin has shown a more manageable and safer profile than prazosin.
In fact, doxazosin is a long-acting α1-blocker, thus it is taken only once/day.
Doxazosin is also less likely to give hypotensive side-effects.
Thus, doxazosin is more commonly used in clinical practice to treat HTN and/or BPH, than short-acting α1-blockers, such as prazosin.
Poor adherence to medications and/or side-effects represent important factors limiting the effectiveness of pharmacotherapies for patients with AD.
If effective for AD, doxazosin may represent a simple, manageable and safe medication, which might be more easily transferable to clinical practice.
However, doxazosin has never been tested in AD.
This project is a 10-week, double-blind, placebo-controlled, between-subject randomized clinical trial with doxazosin (16mg once/day) in alcohol dependent (AD) individuals.
This study attempts to address whether doxazosin is an effective and safe pharmacotherapy for AD.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
48
Phase
- Phase 2
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
-
-
Rhode Island
-
Providence, Rhode Island, United States, 02903
- Brown University Center for Alcohol and Addiction Studies
-
-
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 and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- age ≥18
- females must be post-menopausal for ≥1 year, surgically sterile, or practicing a birth control before entry and throughout the study; have a negative urine pregnancy test at screening and before randomization
- good health (confirmed by medical history, physical, ECG, blood/urine labs)
- DSM-IV diagnosis of AD
- average of ≥4 drinks/d for women and ≥5 drinks/d for men during 30 days within the 90 days prior to screening
- desire to reduce or quit drinking.
Exclusion Criteria:
- females who are of child bearing potential and not practicing effective birth control
- lifetime DSM-IV diagnosis of schizophrenia, bipolar disorder, or other psychosis
- recent (past 6 months) DSM-IV diagnosis of any anxiety disorder or major depression
- in the investigators' opinion, risk of suicide (e.g. active plan, or recent attempt in last year)
- DSM-IV diagnosis of dependence on any psychoactive substance other than alcohol and nicotine
- positive urine screen for any illegal substance other than marijuana
- history of hospitalization for alcohol intoxication delirium, seizure or alcohol withdrawal delirium
- Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) score ≥10, at any assessment
- treatment with naltrexone, acamprosate, topiramate, disulfiram within 1 month prior to Wk 00
- current use of psychotropic medications or drugs that interfere with doxazosin's metabolism
- use of PDE5 inhibitor erectile dysfunction drugs (e.g. sildenafil)
- treatment with any antihypertensive drug and/or any α-blocker for BPH or sleep problems (e.g. trazodone)
- baseline hypotension
- history of allergy to any α-blocker
- contraindications to take doxazosin (history of fainting and/or syncopal attacks, heart failure, significant liver diseases)
- serious illnesses, e.g. kidney failure, epilepsy.
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: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Doxazosin
Doxazosin 16mg/day
|
Doxazosin 16mg/day
|
Placebo Comparator: Placebo
Placeno
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
drinking days per week (DDW)
Time Frame: 16 weeks
|
whether doxazosin, as compared to placebo, decreases the number of drinking days per week (DDW), as measured by the timeline follow-back (TLFB).
A drink is defined as a Standard Drinking Unit (SDU).
|
16 weeks
|
drinks per week (DPW)
Time Frame: 16 weeks
|
whether doxazosin, as compared to placebo, decreases the number of drinks per week (DPW), measured by the TLFB
|
16 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
alcohol craving
Time Frame: 16 weeks
|
whether doxazosin, as compared to placebo, results in diminished alcohol craving, as measured by the Obsessive Compulsive Drinking Scale (OCDS)
|
16 weeks
|
anxiety
Time Frame: 16 weeks
|
whether doxazosin, as compared to placebo, results in diminished anxiety scores, measured by the Hamilton Anxiety Scale (HAMA).
|
16 weeks
|
Adverse Events
Time Frame: 16 weeks
|
whether doxazosin, as compared to placebo, increases the frequency and intensity of Adverse Events (AE).
|
16 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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
November 1, 2011
Primary Completion (Actual)
August 1, 2013
Study Completion (Actual)
March 1, 2015
Study Registration Dates
First Submitted
September 19, 2011
First Submitted That Met QC Criteria
September 19, 2011
First Posted (Estimate)
September 20, 2011
Study Record Updates
Last Update Posted (Estimate)
July 22, 2015
Last Update Submitted That Met QC Criteria
July 20, 2015
Last Verified
July 1, 2015
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mental Disorders
- Chemically-Induced Disorders
- Alcohol-Related Disorders
- Substance-Related Disorders
- Alcoholism
- Physiological Effects of Drugs
- Adrenergic Antagonists
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Antihypertensive Agents
- Adrenergic alpha-1 Receptor Antagonists
- Adrenergic alpha-Antagonists
- Doxazosin
Other Study ID Numbers
- 1101000328
- 1R21AA019994-01A1 (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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