AlcoholismNCT00536146
The Stress-Hormone System in Alcohol-Dependent Subjects
An observational study of Alcoholism, run by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at 2 sites in United States.
Trial summary
This study, conducted at the University of Texas Southwestern Medical Center and the Parkland Hospital in Dallas, will examine the stress hormone system of alcohol-dependent people. This system is weakened in alcohol-addicted people. Read more about this study
- Who is it for?
- Ages 21 to 60 years, men only
- Conditions the study is for
- Alcoholism
- How many people
- 70 participants
- Where
- 2 sitesUnited States
- Study dates
- 24 Sep 2007to 29 Jan 2009
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 to 60 years
- Men only
- No healthy volunteers
- Adult
Who may be able to join
- Alcohol-Dependent Subjects:
- Male, 21-60 yrs, DSM-IV diagnosis of alcohol dependence, 4-6 weeks abstinence; Alcohol intake of at least 80 grams of absolute alcohol (approximately one six-pack of beer or one-half pint of 100% proof distilled spirits) on a daily basis for at least two weeks prior to the cessation of drinking. Years drinking: at least 5 yr history of active alcohol dependence; Lifetime drug of choice is alcohol; requesting treatment in long-term residential program.
- Healthy Controls:
- Thirty men age-matched (plus or minus 5 years) with the patients will be studied. Previous studies have typically used the presence or absence of trauma to define trauma groups. However, these studies have focused on specific types of trauma (i.e. childhood, combat) rather than trauma as a cumulative experience. It is unlikely that we will be able to find subjects who have never experienced any trauma, including the death of loved ones, parental separation, natural disaster, crime, etc. Therefore, we will initially recruit controls without regard to trauma level. Following the recruitment of the first ten subjects, trauma scores will be reviewed. If our control group endorses low levels of trauma, we will direct further recruitment towards a group with at least one self-report of significant lifetime trauma such that at 50 percent of the control population has a least one significant lifetime traumatic event.
- Only English-speaking subjects will be included. Several of the study questionnaires are only available in English. In addition, these studies are exploratory and require the induction of anxiety. The investigators at TSMC believe it prudent to assure that all subjects are able to communicate easily with all staff during the fMRI and stress induction. Subjects will be recruited from subjects requesting treatment for alcohol dependence at the Dallas VA but no subjects will be seen at NIH.
Who cannot join
- Alcohol-Dependent Subjects:
- Primary psychoactive dependence disorder other than alcohol, except nicotine and caffeine.
- Active diagnosis of Axis I Schizophrenia, Mood, or Anxiety Disorders (except PTSD).
- Use of medications known to significantly affect HPA axis functioning or neural activity, including all psychotropics with the previous two weeks (or four weeks for fluoxetine).
- Use of medications known to significantly affect HPA axis functioning or neural activity, including all psychotropics with the previous two weeks (or four weeks for fluoxetine). Patients concomitantly using anxiolytics, antidepressants, opioids, lithium, anticonvulsants, sedative/hypnotics, buspirone, beta blockers, alpha adrenergic drugs, steroids, beta agonists, clonidine, dopamine agonists, naltrexone, acamprosate, or disulfiram will be excluded from the study.
- Any medical conditions that might affect HPA axis functioning or possibly endanger the patient's health or behavioral stability. Medical conditions that might limit cooperation (e.g. dementia) or put the patient at medical risk (i.e. significant hematologic, hepatic, renal, or cardiovascular pathology) will be excluded. Patients with past or present neurologic disorders (i.e. head trauma with loss of consciousness requiring hospitalization, transient ischemic attacks, stroke, tumor, etc.) will be excluded.
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- Healthy Controls:
- Lifetime history of DSM IV Substance Use Disorder (except Nicotine or Caffeine Dependence) or other Axis I disorder.
- One first-degree family member with a substance use disorder (other than nicotine).
- Medical, psychiatric, and medication exclusions will be the same as those described for the alcohol dependent patients.
Trial locations and contacts
2 sites in 1 country.
United States2 sites
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
Veterans Affairs Medical Center at Dallas
Dallas, Texas
About this study
Official title: Trauma, Stress and Persistence of HPA Dysregulation in Alcoholism
This study, conducted at the University of Texas Southwestern Medical Center and the Parkland Hospital in Dallas, will examine the stress hormone system of alcohol-dependent people. This system is weakened in alcohol-addicted people. This study will determine how long it is weakened, whether other hormone systems are also weakened and whether changes in the hormone system are associated with previous trauma or stress.
Healthy normal men and men who are alcohol-dependent may be eligible for this study. Candidates must be between 21 and 60 years of age and have at least a 5-year history of active alcohol dependence. They are screened with a medical history, blood and urine tests and questions about alcohol and drug use, psychiatric problems, history of trauma and recent stress.
Read more
Participants undergo the following procedures:
Day 1 - Public Speaking Task
At 6:00 PM subjects have an I.V. line (needle attached to a small plastic tube) inserted into a vein in each arm to draw blood samples and give medication. They are then given a light dinner and then lie down and rest. They rinse their mouth out with water and a drop of lemon juice is placed on their tongue. In 30 to 40 seconds they spit into a funnel attached to a collecting tube. A blood sample is collected to measure levels of cortisol (a stress hormone) ACTH (a hormone responsible for the release of cortisol) and neurosteroids (hormones that affect the brain). Subjects then give a 5-minute speech (telling an ending to a story) and solve a math problem in front of a small group of people. They are then asked how they are feeling. Saliva and blood samples are then collected every 10 minutes for the next 60 minutes.
Day 2 - Cosyntropin Study
At 6:30 p.m. subjects have an I.V. line inserted into a vein in each arm. At 7:45 PM and 8:30 PM saliva is collected as described above. Starting at 7:30 PM, blood samples are collected every 10 minutes until 9:00 PM and then every 20 minutes until 10:00 PM. At 8:00 PM cosyntropin (a medicine that stimulates production of cortisol) is given through the I.V. over 1 minute.
Day 3 - oCRH Study
At 6:30 p.m. subjects have an I.V. line inserted into a vein in each arm. At 7:45 PM and 8:30 PM saliva is collected as described above. Starting at 7:30 PM, blood samples are collected every 10 minutes until 9:00 PM and then every 20 minutes until 10:00 PM. At 8:00 PM ovine CRH (a medicine that stimulates production of cortisol) is given through the I.V. over 1 minute.
Participants may be asked to repeat these studies 3 months later.
Read the detailed description
The hypothalamic-pituitary-adrenal (HPA) axis provides a key biologic link between the brain and the body's behavioral and physiologic responses to stress, recovery, and adaptation. Both mental trauma and chronic alcohol use may produce disturbances in the HPA response to stress. Thus, changes in this system during a period when there is no alcohol intake may impair the body's ability to mount an appropriate response to environmental stressors, heightening the probability of additional alcohol intake. However, the relationship between trauma, stress, and HPA axis disturbances requires further study. In this study, the NIH investigators will attempt to determine if the sensitivity of glucocorticoid gene induction varies with stress. Blood samples will be obtained at The University of Texas Southwestern Medical Center (TSMC) in collaboration with the Veteran's Affairs Medical Center (VA) at Dallas, Texas under a protocol and consent forms approved by TSMC IRB. Only samples collected as described in the TSMC protocol will be studied at NIH.
- Conditions
- Alcoholism
- Keywords
- Glucocorticoid, Steroids, Dose-Responsive Curve, EC50, Stress Response, Alcoholism
- Medical subject headings
- Alcoholism, Fractures, Stress
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Sep 2007 (estimated)
- Study start24 Sep 2007
- Study completion29 Jan 2009
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for AlcoholismStudies of the same condition, open and under way.
- More trials run by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Time perspective
- Prospective
- Enrolment
- 70 participants
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00536146
- Sponsor's protocol ID
- 999907216
- Other IDs
- 07-DK-N216
- Status last verified
- 29 Jan 2009
- First submitted
- 26 Sep 2007
- Last updated
- 2 Jul 2017
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 2 Jul 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Trauma, Stress and Persistence of HPA Dysregulation in Alcoholism
- ClinicalTrials.gov ID
- NCT00536146
- Acronym / sponsor ID
- 999907216
- Conditions
- Alcoholism
- Keywords
- Glucocorticoid, Steroids, Dose-Responsive Curve, EC50, Stress Response, Alcoholism
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 70 participants
- Lead sponsor
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)US National Institutes of Health
- Study start
- 24 Sep 2007
- Study completion
- 29 Jan 2009
- First posted
- 27 Sep 2007 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study, conducted at the University of Texas Southwestern Medical Center and the Parkland Hospital in Dallas, will examine the stress hormone system of alcohol-dependent people. This system is weakened in alcohol-addicted people. This study will determine how long it is weakened, whether other hormone systems are also weakened and whether changes in the hormone system are associated with previous trauma or stress.
Healthy normal men and men who are alcohol-dependent may be eligible for this study. Candidates must be between 21 and 60 years of age and have at least a 5-year history of active alcohol dependence. They are screened with a medical history, blood and urine tests and questions about alcohol and drug use, psychiatric problems, history of trauma and recent stress.
Participants undergo the following procedures:
Day 1 - Public Speaking Task
At 6:00 PM subjects have an I.V. line (needle attached to a small plastic tube) inserted into a vein in each arm to draw blood samples and give medication. They are then given a light dinner and then lie down and rest. They rinse their mouth out with water and a drop of lemon juice is placed on their tongue. In 30 to 40 seconds they spit into a funnel attached to a collecting tube. A blood sample is collected to measure levels of cortisol (a stress hormone) ACTH (a hormone responsible for the release of cortisol) and neurosteroids (hormones that affect the brain). Subjects then give a 5-minute speech (telling an ending to a story) and solve a math problem in front of a small group of people. They are then asked how they are feeling. Saliva and blood samples are then collected every 10 minutes for the next 60 minutes.
Day 2 - Cosyntropin Study
At 6:30 p.m. subjects have an I.V. line inserted into a vein in each arm. At 7:45 PM and 8:30 PM saliva is collected as described above. Starting at 7:30 PM, blood samples are collected every 10 minutes until 9:00 PM and then every 20 minutes until 10:00 PM. At 8:00 PM cosyntropin (a medicine that stimulates production of cortisol) is given through the I.V. over 1 minute.
Day 3 - oCRH Study
At 6:30 p.m. subjects have an I.V. line inserted into a vein in each arm. At 7:45 PM and 8:30 PM saliva is collected as described above. Starting at 7:30 PM, blood samples are collected every 10 minutes until 9:00 PM and then every 20 minutes until 10:00 PM. At 8:00 PM ovine CRH (a medicine that stimulates production of cortisol) is given through the I.V. over 1 minute.
Participants may be asked to repeat these studies 3 months later.
Detailed description
The hypothalamic-pituitary-adrenal (HPA) axis provides a key biologic link between the brain and the body's behavioral and physiologic responses to stress, recovery, and adaptation. Both mental trauma and chronic alcohol use may produce disturbances in the HPA response to stress. Thus, changes in this system during a period when there is no alcohol intake may impair the body's ability to mount an appropriate response to environmental stressors, heightening the probability of additional alcohol intake. However, the relationship between trauma, stress, and HPA axis disturbances requires further study. In this study, the NIH investigators will attempt to determine if the sensitivity of glucocorticoid gene induction varies with stress. Blood samples will be obtained at The University of Texas Southwestern Medical Center (TSMC) in collaboration with the Veteran's Affairs Medical Center (VA) at Dallas, Texas under a protocol and consent forms approved by TSMC IRB. Only samples collected as described in the TSMC protocol will be studied at NIH.
Study design
- Time perspective
- Prospective
Who may qualify
- Ages
- 21 to 60 years
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Male, 21-60 yrs, DSM-IV diagnosis of alcohol dependence, 4-6 weeks abstinence; Alcohol intake of at least 80 grams of absolute alcohol (approximately one six-pack of beer or one-half pint of 100% proof distilled spirits) on a daily basis for at least two weeks prior to the cessation of drinking. Years drinking: at least 5 yr history of active alcohol dependence; Lifetime drug of choice is alcohol; requesting treatment in long-term residential program.
- Thirty men age-matched (plus or minus 5 years) with the patients will be studied. Previous studies have typically used the presence or absence of trauma to define trauma groups. However, these studies have focused on specific types of trauma (i.e. childhood, combat) rather than trauma as a cumulative experience. It is unlikely that we will be able to find subjects who have never experienced any trauma, including the death of loved ones, parental separation, natural disaster, crime, etc. Therefore, we will initially recruit controls without regard to trauma level. Following the recruitment of the first ten subjects, trauma scores will be reviewed. If our control group endorses low levels of trauma, we will direct further recruitment towards a group with at least one self-report of significant lifetime trauma such that at 50 percent of the control population has a least one significant lifetime traumatic event.
- Only English-speaking subjects will be included. Several of the study questionnaires are only available in English. In addition, these studies are exploratory and require the induction of anxiety. The investigators at TSMC believe it prudent to assure that all subjects are able to communicate easily with all staff during the fMRI and stress induction. Subjects will be recruited from subjects requesting treatment for alcohol dependence at the Dallas VA but no subjects will be seen at NIH.
Key exclusion criteria (10 listed)
- Primary psychoactive dependence disorder other than alcohol, except nicotine and caffeine.
- Active diagnosis of Axis I Schizophrenia, Mood, or Anxiety Disorders (except PTSD).
- Use of medications known to significantly affect HPA axis functioning or neural activity, including all psychotropics with the previous two weeks (or four weeks for fluoxetine).
- Use of medications known to significantly affect HPA axis functioning or neural activity, including all psychotropics with the previous two weeks (or four weeks for fluoxetine). Patients concomitantly using anxiolytics, antidepressants, opioids, lithium, anticonvulsants, sedative/hypnotics, buspirone, beta blockers, alpha adrenergic drugs, steroids, beta agonists, clonidine, dopamine agonists, naltrexone, acamprosate, or disulfiram will be excluded from the study.
- Any medical conditions that might affect HPA axis functioning or possibly endanger the patient's health or behavioral stability. Medical conditions that might limit cooperation (e.g. dementia) or put the patient at medical risk (i.e. significant hematologic, hepatic, renal, or cardiovascular pathology) will be excluded. Patients with past or present neurologic disorders (i.e. head trauma with loss of consciousness requiring hospitalization, transient ischemic attacks, stroke, tumor, etc.) will be excluded.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jul 2017.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Alcoholism, run by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at 2 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 2 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jul 2017.