- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00330187
Combined Pharmaco/Behavior Therapy in Adolescent Smokers
In the current proposal, we intend to study the efficacy of bupropion SR with or without combined contingency management (CM) among adolescent cigarette smokers. The proposed study will test not only medication (bupropion SR), but also combination of medication and CM in potentially improving smoking cessation outcomes AND retention of adolescent smokers in the study.
Hypothesis to be tested: Bupropion SR treatment will increase abstinence from cigarette smoking (as measured by urine cotinine and continuous abstinence) in adolescent smokers as compared to treatment with placebo only.
Hypothesis to be tested: Adolescent smokers treated with combined bupropion SR + contingency management (CM) treatment will have increased retention and increased abstinence rates when compared to bupropion SR alone or CM + placebo treated groups (as measured by decreased drop-out of participants, urine cotinine and continuous abstinence).
Hypothesis to be tested: CM will increase the abstinence from cigarette smoking (as measured by urine cotinine and continuous abstinence) in adolescent smokers as compared to treatment with placebo only.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
To test the hypotheses, 216 adolescent smokers will be recruited. Fifty-four adolescent smokers will be recruited in each of the four groups: bupropion SR only, bupropion SR + CM, CM + placebo, and placebo only. The cells will be balanced for gender and attention deficit hyperactivity disorder using permuted block randomization. A counseling intervention was added for all groups because it was reasoned that it would be unethical not to provide an active treatment to cigarette smoking adolescents. The counseling intervention will consist of two quit smoking brochures that provide information on tips to help quit smoking.
The study will consist of a one-week lead in period followed by a six-week treatment trial. For the medication groups, medications will be titrated during the one-week lead-in period. The primary outcome measure is urine cotinine and self-report of cigarette use collected using the Time-Line Follow-Back at the end of six weeks.
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
-
-
South Carolina
-
Charleston, South Carolina, Forenede Stater, 29425
- Medical University of South Carolina
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Regular cigarette smokers smoking at least 5 cigarettes per day as derived by Time-Line Follow-Back method (Sobell et al., 1988). Average number of cigarettes per day (over past 30 days) will be used. Five cigarettes per day may seem low, but based on previous studies, adolescents tend to smoke fewer cigarettes per day as compared to adults.
- Baseline urine cotinine level greater than 100 ng/ml.
- Age range of 12 - 21
- If under 18 yr. of age, parent(s) or guardian(s) able to participate in informed consent and initial assessment, or the participant must provide evidence of emancipated status.
- For post menarchal female participants: agree to use birth control to avoid pregnancy.
Exclusion Criteria:
- Active substance abuse/dependence (other than nicotine) within 2 weeks prior to participating in the study
- Lifetime bipolar affective disorder (BPAD), psychosis, eating disorders. Bupropion may have adverse consequence on participants with these psychiatric diagnoses.
- Current major depressive disorders. Since bupropion is also an antidepressant, this criteria is to minimize the confound of depressive disorder during the study. History of depressive disorders and current attention deficit hyperactivity disorder (ADHD) will not be an exclusion. We will use permuted block randomization procedure to balance the groups for ADHD.
- Pregnancy or lactation. The safety of bupropion in pregnancy and during lactation is not well studied.
- History of seizure disorder or predisposition to seizures (e.g., history of significant head trauma, currently taking medications that lower seizure threshold), since bupropion can lower seizure threshold.
- History of severe renal, hepatic, neurological, or chronic pulmonary disease. This criterion was chosen due to the hepatic metabolism of bupropion.
- Unstable medical problems
- Allergy to bupropion
- Current treatment with any other medication containing bupropion
- Current treatment with any monoamine oxidase (MAO) inhibitors currently or within 2 weeks of starting the study since there may be serious and severe medical interactions between MAO inhibitors and bupropion SR.
- Current treatment with nicotine replacement therapy (NRT)
- History of intolerance or non-response to bupropion SR.
- Current (past month) suicide ideation
- Suicide attempt (past year)
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Bupropion SR + Contingency Management
Bupropion SR capsules, with goal dose of 300 mg/day, for 6 weeks of treatment.
Contingency Management, with escalating rewards for abstinence (and re-sets for non-abstinence) at twice-weekly visits.
|
Bupropion SR, with goal dose 300 mg/day, for 6 weeks of active treatment
Contingency Management provided at twice-weekly visits during the 6-week active treatment.
Escalating schedule, with resets, reinforcing smoking abstinence.
|
|
Aktiv komparator: Placebo + Contingency Management
Placebo capsules, matched in appearance to Bupropion SR capsules, for 6 weeks of treatment.
Contingency Management, with escalating rewards for abstinence (and re-sets for non-abstinence) at twice-weekly visits.
|
Contingency Management provided at twice-weekly visits during the 6-week active treatment.
Escalating schedule, with resets, reinforcing smoking abstinence.
Placebo, matched in appearance to Bupropion SR, for 6 weeks of treatment
|
|
Aktiv komparator: Bupropion SR + No Contingency Management
Bupropion SR capsules, with goal dose of 300 mg/day, for 6 weeks of treatment.
Contingency Management is not provided in this arm.
|
Bupropion SR, with goal dose 300 mg/day, for 6 weeks of active treatment
|
|
Placebo komparator: Placebo + No Contingency Management
Placebo capsules, matched in appearance to Bupropion SR capsules, for 6 weeks of treatment.
Contingency Management is not provided in this arm.
|
Placebo, matched in appearance to Bupropion SR, for 6 weeks of treatment
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Biologically-verified 7-day Point Prevalence Smoking Abstinence
Tidsramme: End of treatment (week 6)
|
Self-reported abstinence for the past 7 days, confirmed by urine cotinine ≤100 ng/mL
|
End of treatment (week 6)
|
Samarbejdspartnere og efterforskere
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Himanshu P Upadhyaya, MS, MBBS, Medical University of South Carolina
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Psykiske lidelser
- Kemisk inducerede lidelser
- Stof-relaterede lidelser
- Tobaksbrugsforstyrrelse
- Lægemidlers fysiologiske virkninger
- Neurotransmittermidler
- Molekylære mekanismer for farmakologisk virkning
- Enzymhæmmere
- Psykotropiske stoffer
- Neurotransmitter optagelseshæmmere
- Membrantransportmodulatorer
- Antidepressive midler
- Dopaminmidler
- Cytokrom P-450 enzymhæmmere
- Antidepressive midler, anden generation
- Cytokrom P-450 CYP2D6-hæmmere
- Dopaminoptagelseshæmmere
- Bupropion
Andre undersøgelses-id-numre
- DA17460
- R01DA017460 (U.S. NIH-bevilling/kontrakt)
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