Glutamatergic Modulation of Cocaine-related Deficits
2019年4月16日 更新者：Elias Dakwar、New York State Psychiatric Institute
The Effect of Ketamine on Reducing Cue Reactivity in Cocaine Users
Cocaine dependence involves problematic neuroadaptations, such as heightened reactivity to cocaine cues, that may be responsive to pharmacological modulation of glutamatergic circuits.
Despite promising preclinical findings with n-methyl-d-aspartate receptor (NMDAr) modulators, studies with human subjects have been unsuccessful to date.
The purpose of this investigation is to examine the effects of the NMDAr antagonist ketamine, recently found to have potent therapeutic effects in humans, on cue-induced craving and impaired motivation for quitting cocaine in cocaine dependent participants, 24-hours post-infusion.
研究概览
详细说明
In this study, volunteers will undergo a 9 day inpatient trial during which they will receive three counter-balanced infusions (two doses of ketamine and a dose of lorazepam) on three separate days in a within-subject, double-blind, controlled design.
Of the various glutamate antagonists available for human use, ketamine will be utilized because its safety profile, pharmacokinetics, and range of tolerable sub-anesthetic dosings have been very well studied.
Also, ketamine has shown promise in managing opiate and alcohol use disorders in certain studies, and may therefore be the most likely glutamate antagonist to dampen cue reactivity and increase motivation in cocaine users.
If ketamine significantly improves these deficits, this would suggest that the drug should be investigated further for potential utility as a treatment for cocaine dependence.
研究类型
介入性
注册 (实际的)
8
阶段
- 阶段2
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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New York
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New York、New York、美国、10032
- NYSPI
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-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
21年 至 52年 (成人)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria
- Active free-base cocaine dependence (at least 4 days of use over the past month, with at least 1 use per week); if the participant uses through another route (IN, IV), then the FB route is dominant (> 80% of occasions).
- Physically healthy
- No adverse reactions to study medications
- 21-52 years of age
- Normal body weight
- Responsive to drug cues
- Capacity to consent
Exclusion Criteria:
- Seeking treatment or abstinence
- DSM IV criteria for substance dependence (other than methamphetamine, cocaine, cannabis, or nicotine), or DSM IV criteria for abuse of ketamine or lorazepam
- DSM-IV criteria for other Axis I psychiatric illness that may make participation hazardous such as schizophrenia, schizoaffective disorder, psychosis NOS, MDD, psychosis secondary to substances, or bipolar disorder
- Delirium, Dementia, Amnesia, Cognitive Disorders, or dissociative disorders
- Current suicide risk or a history of suicide attempt within the past 2 years
- Current use of prescribed psychotropic medication
- Pregnancy, nursing, or had a baby within the past 6 mo.
- Heart disease as indicated by history, abnormal ECG, previous cardiac surgery.
- Unstable physical disorders which might make participation hazardous such as end-stage AIDS, hypertension (>140/90), anemia, active hepatitis or other liver disease, or diabetes
- "Bad" reaction/experience with prior exposure to ketamine or lorazepam
- History of significant violence
- First degree relative with a psychotic disorder
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：交叉作业
- 屏蔽：三倍
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：K1
Ketamine 0.41 mg/kg infused over 52 min (K1)
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52 minute iv infusion of ketamine 0.41 mg/kg
其他名称：
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实验性的：K2
Ketamine 0.71 mg/kg infused over 52 min (K2)
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52 minute iv infusion of ketamine 0.71 mg/kg.
This dose follows K1 in all 3 orderings.
其他名称：
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实验性的：LZP
Lorazepam 2 mg infused over 52 minutes (LZP)
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52 minute infusion of lorazepam 2 mg.
This serves as an active control.
其他名称：
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Change in Cue Reactivity
大体时间：Baseline and 24 hours after infusion
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Serial visual analogue scale (VAS) scores for craving elicited by cocaine cue: units on a scale (0-200), high is worse.
Scores are obtained at baseline and at 24 hours after the infusion.
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Baseline and 24 hours after infusion
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Change in Motivation to Quit
大体时间：Baseline and 24 hours post-infusion
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Motivation score obtained from the University of Rhode Island Change Assessment (URICA).
Scores are obtained at baseline and at 24 hours after each infusion.
The scores are 0-13, with higher scores indicating greater motivation.
The analysis is within-subject.
Scores included below are means; higher scores represent higher motivation to quit than do lower scores.
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Baseline and 24 hours post-infusion
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Elias Dakwar, MD、NYSPI/Columbia College of Physicians and Surgeons
- 学习椅：Carl Hart, PhD、NYSPI/Columbia College of Physicians and Surgeons
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2011年2月1日
初级完成 (实际的)
2012年3月1日
研究完成 (实际的)
2012年3月1日
研究注册日期
首次提交
2013年2月8日
首先提交符合 QC 标准的
2013年2月11日
首次发布 (估计)
2013年2月13日
研究记录更新
最后更新发布 (实际的)
2019年4月30日
上次提交的符合 QC 标准的更新
2019年4月16日
最后验证
2019年4月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
Ketamine 0.41 mg/kg的临床试验
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Rockefeller UniversityBrigham and Women's Hospital; Weill Medical College of Cornell University; University of Cologne完全的
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University of Texas Southwestern Medical CenterGlaxoSmithKline招聘中
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Alexion Pharmaceuticals终止