- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT07641283
Naltrexone for Nonsuicidal Self-Injury
A Randomized, Double-Blinded Clinical Trial to Evaluate the Effectiveness of Naltrexone in Improving Nonsuicidal Self-Injurious Behavior
This randomized, double-blinded, placebo-controlled clinical trial aims to evaluate the efficacy and safety of naltrexone in reducing nonsuicidal self-injurious behavior among individuals with nonsuicidal self-injury. Participants will be randomly assigned to receive either naltrexone plus treatment as usual or placebo plus treatment as usual for 6 weeks.
The primary objective is to determine whether naltrexone reduces the frequency of nonsuicidal self-injurious behavior compared with placebo. Secondary objectives include evaluating changes in clinical severity, suicidal ideation, self-injury-related urges, ecological momentary assessment measures, and safety outcomes.
Studienübersicht
Status
Intervention / Behandlung
Detaillierte Beschreibung
Nonsuicidal self-injury is defined as the intentional destruction of one's own body tissue without suicidal intent. It is clinically important because it is associated with emotional dysregulation, impulsivity, psychiatric comorbidity, and increased risk of future suicidal behavior. However, evidence-based pharmacological treatments specifically targeting nonsuicidal self-injurious behavior remain limited.
Naltrexone is an opioid receptor antagonist that has been suggested to reduce repetitive self-injurious behaviors by modulating endogenous opioid-related reinforcement mechanisms. This study will investigate whether naltrexone is effective in reducing nonsuicidal self-injurious behavior in a randomized, double-blinded, placebo-controlled design.
A total of 150 participants will be enrolled across multiple study sites. Eligible participants will be randomly assigned in a 1:1 ratio to either the naltrexone group or the placebo group. The intervention period will last 6 weeks, with clinical evaluations conducted at baseline and every 2 weeks thereafter. Smartphone-based ecological momentary assessment will also be used to monitor self-injurious urges, mood states, and related behavioral variables during the study period.
Safety will be assessed throughout the study through adverse event monitoring, assessment of suicidal ideation and behavior, laboratory testing, urine testing, and electrocardiography according to the study schedule.
Studientyp
Einschreibung (Geschätzt)
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
- Name: Myeong-hyeon Mun, MD, Master's degree
- Telefonnummer: +821085171499
- E-Mail: psalms139@hanmail.net
Studienorte
-
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Gyeonggi-do
-
Uijeongbu-si, Gyeonggi-do, Südkorea, 11759
- Uijeongbu Eulji Medical Center
-
Kontakt:
- Minseok Hong, MD, PhD
- Telefonnummer: +821032289060
- E-Mail: garam21th@snu.ac.kr
-
-
Jongno-gu
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Seoul, Jongno-gu, Südkorea, 03080
- Seoul National University Hospital
-
Kontakt:
- Myeong-hyeon Mun, MD, Master's degree
- Telefonnummer: +821085171499
- E-Mail: psalms139@hanmail.net
-
-
Songpa-gu
-
Seoul, Songpa-gu, Südkorea, 05505
- Asan Medical Center
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Kontakt:
- Yujin Choi, Bachelor's Degree
- Telefonnummer: +821081194386
- E-Mail: dbwls14615@naver.com
-
-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Kind
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
Participants must meet all of the following criteria:
- Individuals aged 16 years or older.
- Individuals with clinically significant nonsuicidal self-injurious behavior.
- Individuals who are able to understand the study procedures and provide written informed consent. For minors, consent from a legal guardian and assent from the participant will be obtained according to applicable regulations.
- Individuals who are able to comply with study procedures, including clinical visits, medication administration, and study assessments.
- Women of childbearing potential must have a negative urine pregnancy test at screening and agree to use appropriate contraception during the study period.
Exclusion Criteria:
Participants meeting any of the following criteria will be excluded:
- Current serious suicidal ideation or high suicide risk, as determined by the investigator.
- Current opioid use, opioid dependence, or use of opioid-containing medications.
- Current use of opioid antagonists or medications that may interact with naltrexone, including methadone or buprenorphine.
- Use of naltrexone within 1 week before screening.
- Positive naloxone challenge test or positive urine opioid test, if applicable.
- Known hypersensitivity to naltrexone or any component of the investigational product.
- Active liver disease, active hepatitis, or clinically significant hepatic impairment.
- Clinically significant renal impairment.
- Pregnancy or breastfeeding.
- Intellectual disability, organic brain disorder, or other condition that may interfere with the participant's ability to understand study procedures or complete assessments.
- Inability to read or write Korean sufficiently to complete study assessments.
- Documented prior non-response to naltrexone for nonsuicidal self-injury, as judged by the investigator.
- Any other clinically significant medical or psychiatric condition that, in the opinion of the investigator, would make participation inappropriate or unsafe.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Verdreifachen
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: Naltrexone Group
Participants will receive Naltrexone 50mg orally once daily for 6 weeks, in addition to their current Treatment as Usual (TAU).
|
Pure opioid antagonist administered 50mg once daily.
|
|
Placebo-Komparator: Placebo Group
Participants will receive a matching placebo orally once daily for 6 weeks, in addition to their current Treatment as Usual (TAU).
|
Matching placebo indistinguishable from the active drug, administered once daily.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Total Number of Nonsuicidal Self-Injury Episodes During the 6-Week Treatment Period
Zeitfenster: Baseline to Week 6
|
The total number of nonsuicidal self-injury episodes during the 6-week treatment period will be assessed by blinded clinical evaluators.
A lower number indicates fewer nonsuicidal self-injury episodes.
|
Baseline to Week 6
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Change From Baseline in Modified Obsessive Compulsive Drinking Scale Adapted for Nonsuicidal Self-Injury Urges Total Score
Zeitfenster: Baseline, Week 2, Week 4, and Week 6
|
Self-injurious urges will be assessed using the Modified Obsessive Compulsive Drinking Scale adapted for nonsuicidal self-injury urges.
The total score ranges from 0 to 56, with higher scores indicating more severe self-injurious urges.
|
Baseline, Week 2, Week 4, and Week 6
|
|
Change From Baseline in Columbia-Suicide Severity Rating Scale Suicidal Ideation Severity Score
Zeitfenster: Baseline, Week 2, Week 4, and Week 6
|
Suicidal ideation will be assessed using the Columbia-Suicide Severity Rating Scale suicidal ideation severity score.
The score ranges from 0 to 5, with higher scores indicating more severe suicidal ideation.
|
Baseline, Week 2, Week 4, and Week 6
|
|
Change From Baseline in Clinical Global Impressions-Severity Score
Zeitfenster: Baseline, Week 2, Week 4, and Week 6
|
Overall clinical severity will be assessed using the Clinical Global Impressions-Severity scale.
The score ranges from 1 to 7, with higher scores indicating greater illness severity.
|
Baseline, Week 2, Week 4, and Week 6
|
|
Number of Event-Based Ecological Momentary Assessment Reports of Nonsuicidal Self-Injury Urges
Zeitfenster: During the 6-week intervention period
|
Participants will complete an event-based smartphone ecological momentary assessment entry when they experience nonsuicidal self-injury urges.
The outcome will be reported as the total number of event-based reports of nonsuicidal self-injury urges.
A higher number indicates more frequent self-injurious urges.
|
During the 6-week intervention period
|
|
Number of Event-Based Ecological Momentary Assessment Reports of Nonsuicidal Self-Injury Behavior
Zeitfenster: During the 6-week intervention period
|
Participants will complete an event-based smartphone ecological momentary assessment entry when nonsuicidal self-injury behavior occurs.
The outcome will be reported as the total number of event-based reports of nonsuicidal self-injury behavior.
A higher number indicates more frequent nonsuicidal self-injury behavior.
|
During the 6-week intervention period
|
|
Percentage of Planned Investigational Product Doses Taken as Assessed by Pill Count
Zeitfenster: Week 2, Week 4, and Week 6
|
Medication adherence will be assessed using pill count.
Adherence will be calculated as the number of doses taken divided by the number of planned doses, multiplied by 100.
The percentage ranges from 0% to 100%, with higher percentages indicating greater adherence.
|
Week 2, Week 4, and Week 6
|
|
Number of Participants With Treatment-Emergent Adverse Events
Zeitfenster: Baseline through Week 6
|
Treatment-emergent adverse events will be assessed throughout the study period.
The outcome will be reported as the number of participants with one or more treatment-emergent adverse events.
|
Baseline through Week 6
|
|
Number of Participants With Clinically Significant Laboratory Abnormalities
Zeitfenster: Baseline and Week 6
|
Laboratory safety will be assessed using prespecified blood and urine tests.
The outcome will be reported as the number of participants with clinically significant laboratory abnormalities as judged by the investigator.
|
Baseline and Week 6
|
|
Number of Participants With Clinically Significant Electrocardiogram Abnormalities
Zeitfenster: Baseline and Week 6
|
Electrocardiogram safety will be assessed using standard electrocardiography.
The outcome will be reported as the number of participants with clinically significant electrocardiogram abnormalities as judged by the investigator.
|
Baseline and Week 6
|
|
Change From Baseline in Montgomery-Åsberg Depression Rating Scale Total Score
Zeitfenster: Baseline, Week 2, Week 4, and Week 6
|
Depressive symptoms will be assessed using the Montgomery-Åsberg Depression Rating Scale.
The total score ranges from 0 to 60, with higher scores indicating more severe depressive symptoms.
|
Baseline, Week 2, Week 4, and Week 6
|
|
Change From Baseline in Hamilton Rating Scale for Anxiety Total Score
Zeitfenster: Baseline, Week 2, Week 4, and Week 6
|
Anxiety symptoms will be assessed using the Hamilton Rating Scale for Anxiety.
The total score ranges from 0 to 56, with higher scores indicating more severe anxiety symptoms.
|
Baseline, Week 2, Week 4, and Week 6
|
|
Change From Baseline in Patient Health Questionnaire-9 Total Score
Zeitfenster: Baseline, Week 2, Week 4, and Week 6
|
Self-reported depressive symptoms will be assessed using the Patient Health Questionnaire-9.
The total score ranges from 0 to 27, with higher scores indicating more severe depressive symptoms.
|
Baseline, Week 2, Week 4, and Week 6
|
|
Change From Baseline in Generalized Anxiety Disorder-7 Total Score
Zeitfenster: Baseline, Week 2, Week 4, and Week 6
|
Self-reported anxiety symptoms will be assessed using the Generalized Anxiety Disorder-7 scale.
The total score ranges from 0 to 21, with higher scores indicating more severe anxiety symptoms.
|
Baseline, Week 2, Week 4, and Week 6
|
|
Change From Baseline in Eating Disorder Examination-Questionnaire Global Score
Zeitfenster: Baseline and Week 6
|
Eating disorder-related psychopathology will be assessed using the Eating Disorder Examination-Questionnaire global score.
The global score ranges from 0 to 6, with higher scores indicating greater eating disorder-related psychopathology.
|
Baseline and Week 6
|
|
Clinical Global Impressions-Improvement Score
Zeitfenster: Week 2, Week 4, and Week 6
|
Overall clinical improvement will be assessed using the Clinical Global Impressions-Improvement scale.
The score ranges from 1 to 7, where 1 indicates very much improved and 7 indicates very much worse.
Lower scores indicate greater improvement.
|
Week 2, Week 4, and Week 6
|
|
Weekly Positive Affect Score as Assessed by the Positive and Negative Affect Schedule
Zeitfenster: Weekly during the 6-week intervention period
|
Positive affect will be assessed weekly using the Positive and Negative Affect Schedule positive affect subscale through smartphone-based ecological momentary assessment.
The positive affect subscale score ranges from 10 to 50, with higher scores indicating greater positive affect.
|
Weekly during the 6-week intervention period
|
|
Weekly Negative Affect Score as Assessed by the Positive and Negative Affect Schedule
Zeitfenster: Weekly during the 6-week intervention period
|
Negative affect will be assessed weekly using the Positive and Negative Affect Schedule negative affect subscale through smartphone-based ecological momentary assessment.
The negative affect subscale score ranges from 10 to 50, with higher scores indicating greater negative affect.
|
Weekly during the 6-week intervention period
|
Mitarbeiter und Ermittler
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O'Neal L, McLeod L, Delacqua G, Delacqua F, Kirby J, Duda SN; REDCap Consortium. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019 Jul;95:103208. doi: 10.1016/j.jbi.2019.103208. Epub 2019 May 9.
- Bradburn NM, Rips LJ, Shevell SK. Answering autobiographical questions: the impact of memory and inference on surveys. Science. 1987 Apr 10;236(4798):157-61. doi: 10.1126/science.3563494.
- Clark DM, Teasdale JD. Diurnal variation in clinical depression and accessibility of memories of positive and negative experiences. J Abnorm Psychol. 1982 Apr;91(2):87-95. doi: 10.1037//0021-843x.91.2.87. No abstract available.
- Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4:1-32. doi: 10.1146/annurev.clinpsy.3.022806.091415.
- Sonne S, Rubey R, Brady K, Malcolm R, Morris T. Naltrexone treatment of self-injurious thoughts and behaviors. J Nerv Ment Dis. 1996 Mar;184(3):192-5. doi: 10.1097/00005053-199603000-00011. No abstract available.
- Casner JA, Weinheimer B, Gualtieri CT. Naltrexone and self-injurious behavior: a retrospective population study. J Clin Psychopharmacol. 1996 Oct;16(5):389-94. doi: 10.1097/00004714-199610000-00008.
- Buzan RD, Thomas M, Dubovsky SL, Treadway J. The use of opiate antagonists for recurrent self-injurious behavior. J Neuropsychiatry Clin Neurosci. 1995 Fall;7(4):437-44. doi: 10.1176/jnp.7.4.437.
- Kars H, Broekema W, Glaudemans-van Gelderen I, Verhoeven WM, van Ree JM. Naltrexone attenuates self-injurious behavior in mentally retarded subjects. Biol Psychiatry. 1990 Apr 1;27(7):741-6. doi: 10.1016/0006-3223(90)90589-t.
- McCauley E, Berk MS, Asarnow JR, Adrian M, Cohen J, Korslund K, Avina C, Hughes J, Harned M, Gallop R, Linehan MM. Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A Randomized Clinical Trial. JAMA Psychiatry. 2018 Aug 1;75(8):777-785. doi: 10.1001/jamapsychiatry.2018.1109.
- Mehlum L, Tormoen AJ, Ramberg M, Haga E, Diep LM, Laberg S, Larsson BS, Stanley BH, Miller AL, Sund AM, Groholt B. Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial. J Am Acad Child Adolesc Psychiatry. 2014 Oct;53(10):1082-91. doi: 10.1016/j.jaac.2014.07.003. Epub 2014 Jul 22.
- Aboujaoude E, Salame WO. Naltrexone: A Pan-Addiction Treatment? CNS Drugs. 2016 Aug;30(8):719-33. doi: 10.1007/s40263-016-0373-0.
- Bresin K, Gordon KH. Endogenous opioids and nonsuicidal self-injury: a mechanism of affect regulation. Neurosci Biobehav Rev. 2013 Mar;37(3):374-83. doi: 10.1016/j.neubiorev.2013.01.020. Epub 2013 Jan 20.
- Blasco-Fontecilla H, Fernandez-Fernandez R, Colino L, Fajardo L, Perteguer-Barrio R, de Leon J. The Addictive Model of Self-Harming (Non-suicidal and Suicidal) Behavior. Front Psychiatry. 2016 Feb 1;7:8. doi: 10.3389/fpsyt.2016.00008. eCollection 2016.
- Vega D, Sintes A, Fernandez M, Punti J, Soler J, Santamarina P, Soto A, Lara A, Mendez I, Martinez-Gimenez R, Romero S, Pascual JC. Review and update on non-suicidal self-injury: who, how and why? Actas Esp Psiquiatr. 2018 Jul;46(4):146-55. Epub 2018 Jul 1.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Verhaltenssymptome
- Selbstmord
- Verhalten
- Suizidgedanken
- Impulsives Verhalten
- Selbstverletzendes Verhalten
- Heterocyclische Verbindungen
- Heterocyclische Verbindungen, Fusionsring
- Alkaloide
- Polycyclische aromatische Kohlenwasserstoffe
- Polycyclische Verbindungen
- Heterocyclische Verbindungen, 4 oder mehr Ringe
- Naloxon
- Morphinans
- Opiatalkaloide
- Heterocyclische Verbindungen, Brückenring
- Phenanthrenes
- Naltrexon
Andere Studien-ID-Nummern
- 2024-0057
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