Repetitive Transcranial Magnetic Stimulation for People With Etomidate Addiction (SToP-E-rTMS x Etomidate) (SToP-E)
Substance Misuse To Psychiatric Disorders for Etomidate -Repetitive Transcranial Magnetic Stimulation for People With Etomidate Addiction: a 6-month, Double-blind, Randomized, Sham-controlled Trial
The goal of this clinical trial is to learn if high-frequency rTMS works to treat etomidate addiction in adults. It will also learn about the safety and tolerability of rTMS. The main questions it aims to answer are:
- Does active rTMS reduce craving, amount of etomidate use, frequency of etomidate use, and severity of etomidate use disorder?
- Does active rTMS improve cognitive biases related to delayed reward discounting and risk sensitivity?
- What side-effects do participants have when receiving rTMS?
Researchers will compare active rTMS to sham rTMS to see if active rTMS works to treat etomidate addiction.
Participants will:
- Receive active rTMS or sham rTMS over 4 weeks
- Complete 20 rTMS sessions in total
- Visit the clinic for treatment sessions and follow-up assessments
- Complete assessments of etomidate use, craving, withdrawal symptoms, mood symptoms, cognition, and decision-making
Attend follow-up assessments up to 6 months after baseline
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Descrição detalhada
This is a 6-month, double-blind, randomized, sham-controlled pilot clinical trial evaluating high-frequency repetitive transcranial magnetic stimulation (rTMS) for people with etomidate addiction. Etomidate misuse has become an emerging public health concern, but there is currently no established treatment specifically for etomidate addiction. This study will examine whether active rTMS delivered to the left dorsolateral prefrontal cortex can reduce etomidate craving, use, and dependence severity compared with sham rTMS.
The study will enroll 40 participants with etomidate use disorder. Participants will be randomly assigned in a 1:1 ratio to receive either active rTMS or sham rTMS. Both participants and outcome assessors will be blinded to treatment allocation. The intervention consists of 20 rTMS sessions delivered over 4 weeks, followed by an observation maintenance phase with follow-up assessments up to 6 months from baseline.
The study will assess changes in etomidate use, craving, withdrawal symptoms, dependence severity, anxiety, depression, global cognition, psychomotor speed, and cognitive biases related to delayed reward discounting and risk sensitivity. These assessments will help determine whether rTMS may be a feasible and potentially effective intervention for etomidate addiction and related decision-making processes.
Tipo de estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Estágio
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Albert KK Chung
- Número de telefone: +85260440993
- E-mail: Chungkka@hku.hk
Locais de estudo
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Hong Kong
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Hong Kong, Hong Kong, Hong Kong, 000000
- Queen Mary Hospital
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Contato:
- Ablert KK Chung
- E-mail: chungkka@hku.hk
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Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Able to read and communicate in English and/or Chinese
- Able to give informed consent and/or able to provide an informed consent from the legal guardian (if applicable)
- Using etomidate and/or its related analogues as the primary psychoactive substance of abuse
Suffering from etomidate addiction as defined by:
- Etomidate Use Disorder classified under "Sedative-, Hypnotic-, or Anxiolytic Use Disorder" according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) with severity ≥ 1, or
- Harmful Use or Dependence for etomidate classified under "Mental and behavioral disorders due to use of sedatives or hypnotics" according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10), or
- Hazardous use, harmful use or dependence classified under "Hazardous use of sedatives, hypnotics or anxiolytics" or "Disorders due to use of sedatives, hypnotics or anxiolytics" according to the Clinical descriptions and diagnostic requirements for International Classification of Diseases 11th Revision (ICD-11) mental, behavioral, and neurodevelopmental disorders.
Exclusion Criteria:
- Age < 18 years old
- Unable to read English or Chinese
- Unable to give informed consent
Had been diagnosed with the following disorders including:
1. Neurodevelopmental Disorders:
- DSM-5: Intellectual Disabilities, Communication Disorders, Specific Learning Disorder, Autism Spectrum Disorder and Motor Disorders
- International Statistical Classification of Diseases and Related Health Problems 11th Revision (ICD-11): Disorders of intellectual development (6A00), Developmental speech or language disorders (6A01), Autism spectrum disorder (6A02), Developmental learning disorder (6A03), Developmental motor coordination disorder (6A04), Stereotyped movement disorder (6A06), Primary tics or tic disorders (8A05.0)
- Other DSM-5 defined Substance Use Disorder greater than moderate in severity (i.e., severity score ≥4)
- Neurocognitive Disorders (DSM-5, or ICD-11 6D70-72 & 6D80-86) 2. Contra-indicated to undergo rTMS:
- with electronic and/or magnetic implants (e.g., pacemaker, implantable cardioverter defibrillator [ICD], cerebral shunts, cochlear implant, etc.)
- with metallic or mechanic fragments (e.g., screws, plates, stents, clips, etc.)
- pregnant
- with any known or history of neurological conditions including cerebral vascular accidents (CVA), epilepsy, brain tumor or space occupying lesion, etc.
- poorly controlled or unstable diabetes mellitus
- receiving unstable dose(s) of antipsychotics, antidepressants, benzodiazepines and/or anticonvulsants in the past 3 months
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Triplo
Número de braços
Armas e Intervenções
Grupo de Participantes / BraçoGrupo de Participantes / Braço |
Intervenção / TratamentoIntervenção / Tratamento |
|---|---|
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Experimental: Active rTMS
Subjects receive 20 high-frequency rTMS sessions over 4 weeks.
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high-frequency rTMS using Magventure TMS system using the Coil Cool-B70 Active/Placebo Bended Butterfly coil is delivered at the dorsolateral prefrontal cortex of consented subjects
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Comparador Falso: Sham rTMS
Subjects receive 20 Sham rTMS sessions over 4 weeks.
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Sham rTMS will be delivered using the Coil Cool-B70 Active/Placebo Bended Butterfly coil, which generates a negligible magnetic field.
The sham procedure will follow the same schedule as the active rTMS arm.
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O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in etomidate craving
Prazo: Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in craving measured by the Craving Automated Scale-Substance from baseline to follow-up.
Higher scores indicate stronger craving.
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Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in etomidate withdrawal symptoms
Prazo: Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in withdrawal symptoms measured by the Clinical Institute Withdrawal Assessment for Benzodiazepines from baseline to follow-up.
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Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in amount of etomidate use
Prazo: Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in the amount of etomidate use over the past 30 days measured by the Beat Drugs Fund Evaluation Question Set No. 5 and substance use interview from baseline to follow-up.
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Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in frequency of etomidate use
Prazo: Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in the frequency of etomidate use over the past 30 days measured by the Beat Drugs Fund Evaluation Question Set No. 5 and substance use interview from baseline to follow-up.
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Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in severity of dependence
Prazo: Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in severity of dependence measured by the Severity of Dependence Scale from baseline to follow-up.
Higher scores indicate greater dependence severity.
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Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in urine-confirmed etomidate use
Prazo: Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in etomidate use status assessed by urine test from baseline to follow-up.
Urine testing will be used to assess recent etomidate use and compare biological testing results with self-reported etomidate use.
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Baseline, Week 1, Week 4, Month 3, and Month 6
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Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in anxiety symptoms
Prazo: Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in anxiety symptoms measured by the Beck Anxiety Inventory from baseline to follow-up.
Higher scores indicate more severe anxiety symptoms.
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Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in depressive symptoms
Prazo: Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in depressive symptoms measured by the Beck Depression Inventory-II from baseline to follow-up.
Higher scores indicate more severe depressive symptoms.
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Baseline, Week 1, Week 4, Month 3, and Month 6
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Change in delayed reward discounting
Prazo: Baseline, Week 4, Month 3, and Month 6
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Change in delayed reward discounting measured by a delay discounting task from baseline to follow-up.
The task assesses preference for smaller immediate rewards versus larger delayed rewards.
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Baseline, Week 4, Month 3, and Month 6
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Change in risk sensitivity
Prazo: Baseline, Week 4, Month 3, and Month 6
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Change in risk sensitivity measured by a risk preference task from baseline to follow-up.
The task assesses preference for smaller safe rewards versus larger risky rewards.
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Baseline, Week 4, Month 3, and Month 6
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Change in global cognitive function
Prazo: Baseline, Week 4, Month 3, and Month 6
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Change in global cognitive function measured by the Montreal Cognitive Assessment-Hong Kong Chinese version or English version from baseline to follow-up.
Higher scores indicate better global cognitive function.
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Baseline, Week 4, Month 3, and Month 6
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Change in psychomotor speed
Prazo: Baseline, Week 4, Month 3, and Month 6
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Change in psychomotor speed measured by the Digit Symbol Substitution Test from baseline to follow-up.
Higher scores indicate better psychomotor speed.
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Baseline, Week 4, Month 3, and Month 6
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Albert KK Chung, Department of Psychiatry, The University of Hong Kong
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
Outros números de identificação do estudo
- UW 26-263
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Descrição do plano IPD
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