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Cocaine AddictionPhase 4NCT03018236

Effect of N-acetylcysteine on Alcohol and Cocaine Use Disorders: A Double-Blind Randomized Controlled Trial.

A Phase 4 study testing Alcohol N-acetylcysteine and Cocaine N-acetylcysteine in people with Cocaine Addiction and Alcohol Addiction, run by Hospital de Clinicas de Porto Alegre at 1 site in Brazil.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study evaluates the use of N-acetylcysteine in the treatment of alcohol and cocaine use disorders. Alcohol users will be split in two groups, one will receive the active N-acetylcysteine and the other placebo. The same division will occur with cocaine users. Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Cocaine Addiction, Alcohol Addiction
What is being tested?
Alcohol N-acetylcysteine and Cocaine N-acetylcysteine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
100 participants
Where
1 siteBrazil
Study dates
Jan 2017to Dec 2018
Phase
Phase 4
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 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnostic of Alcohol or Cocaine Use Disorder
  • Seven days of inpatient treatment in an addiction treatment specialized unit

Who cannot join

  • Another Substance Use Disorder (exception: tobacco)
  • Severe medical conditions (cardiac, renal or hepatic), that preclude subject participation
  • History of asthma or convulsions medication use
  • Recent use (<14 days) of any medication that could interfere with the study medication
  • History of anaphylactic reactions with the study medication
  • Suicide risk
Show all 9Show fewer
  • Inability to understand the informed consent form or to comply with the study requirements
  • Any severe neuropsychiatric condition, not caused by the substance use, that requires specific medication treatments and could interfere with the study development, in the investigators opinion (for instance: dementia, schizophrenia or other psychoses, multiple sclerosis, severe depression, stroke, epilepsy, bipolar disorder)
  • Failing to complete the screening procedures prior to the study first week

Trial locations and contacts

1 site in 1 country.

Lisia von Diemen, PhD contact

+55 51 3359 6471

lisiavd@gmail.com

Thiago C Hartmann, MsC contact

+55 51 3359 6476

hartmann321@yahoo.com.br

Brazil1 site, 1 recruiting
  • Hospital de Clinicas de Porto Alegre - Unidade Alvaro Alvim

    Porto Alegre, Rio Grande do Sul, 90420-020

    Thiago C Hartmann, MsC, +55 51 3359 6476, hartmann321@yahoo.com.br

    Recruiting

Other trials in Brazil

About this study

Official title: The Effect of N-acetylcysteine (NAC) on Treatment of Alcohol and Cocaine Use Disorders: A Double-Blind Randomized Controlled Trial.

This study evaluates the use of N-acetylcysteine in the treatment of alcohol and cocaine use disorders. Alcohol users will be split in two groups, one will receive the active N-acetylcysteine and the other placebo. The same division will occur with cocaine users. The effects of N-acetylcysteine in adherence, abstinence, psychiatric symptoms and stress biomarkers will be evaluated.

Read the detailed description

N-acetylcysteine acts replenishing the human body glutathione storages. Glutathione is an important antioxidant agent, and also modulates the N-methyl-D-aspartate (NMDA) glutamatergic receptor. Glutamate has been associated with the neuroadaptation related to substance use disorders, and thus it is considered a potential target for pharmacological interventions regarding these disorders. N-acetylcysteine also interacts with the cystine-glutamate antiporter on astrocytes hence increasing glutamate release into the extracellular space.

N-acetylcysteine effects and its implications in the addiction disorders have been studied initially with animal models. Glutamate levels normalization through N-acetylcysteine reduced compulsive drug self-administration and drug-seeking behavior in mice. In addition, there are promising results also with human subjects, showing benefits for cocaine, alcohol and cannabis use disorders.

This study consists of a randomized, double-blind, placebo controlled trial with four arms: alcohol users divided into NAC vs Placebo and cocaine users divided into NAC vs Placebo.

Being tested
Alcohol N-acetylcysteine, Alcohol Placebo, Cocaine N-acetylcysteine, Cocaine Placebo
Keywords
cocaine, alcohol, substance use disorders, addiction, N-acetylcysteine, randomized controlled trial
Medical subject headings
Cocaine-Related Disorders, Alcoholism, Substance-Related Disorders, Behavior, Addictive

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Alcohol N-acetylcysteineDrug

    Also called NAC

    1200 mg of NAC per day, taken in two doses, for subjects with alcohol use disorder

  • Alcohol PlaceboDrug

    Flour pills looking exactly the same as the active compound, for subjects with alcohol use disorder

  • Cocaine N-acetylcysteineDrug

    Also called NAC

    1200 mg of NAC per day, taken in two doses, for subjects with cocaine use disorder

  • Cocaine PlaceboDrug

    Flour pills looking exactly the same as the active compound, for subjects with cocaine use disorder

Study groups in NCT03018236
Study groupRoleWhat they receive
Alcohol N-acetylcysteineExperimental600 mg N-acetylcysteine capsule by mouth, every 12 hours for 8 weeks
Receives: Drug: Alcohol N-acetylcysteine
Alcohol PlaceboPlacebo comparatorA placebo capsule matching color and smell of the active medication
Receives: Drug: Alcohol Placebo
Cocaine N-acetylcysteineExperimental600 mg N-acetylcysteine capsule by mouth, every 12 hours for 8 weeks
Receives: Drug: Cocaine N-acetylcysteine
Cocaine PlaceboPlacebo comparatorA placebo capsule matching color and smell of the active medication
Receives: Drug: Cocaine Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of participants who attended all study appointments

    Completers (i.e. subjects who attended all study appointments) vs non-completers

    Measured: 8 weeks

Secondary outcomes (16)
  1. Abstinence by urine

    Amount of positive urine tests for cocaine users

    Measured: 8 weeks

  2. Abstinence by breathalyzer

    Amount of positive breathalyzer tests for alcohol users

    Measured: 8 weeks

  3. Abstinence by self report

    Timeline Followback Method

    Measured: 8 weeks

  4. Days of inpatient treatment

    The difference (if any) between placebo and intervention groups in the amount of inpatient treatment days.

    Measured: Up to 4 weeks

  5. Change in scores of CGI

    Differences in scores of the Clinical Global Impression (CGI)

    Measured: 8 weeks

  6. Change in scores of FAST

    Differences in scores of the Functioning Assessment Short Test (FAST).

    Measured: 8 weeks

  7. Depressive symptoms

    Differences in scores of the Beck Depression Inventory (BDI)

    Measured: 8 weeks

  8. Anxiety symptoms

    Differences in scores of the Beck Anxiety Inventory (BAI)

    Measured: 8 weeks

  9. BDNF

    Differences between groups regarding dosage of Brain Derived Neurotrophic Factor (BDNF)

    Measured: 8 weeks

  10. GSSG

    Differences between groups regarding dosage of Oxidized Glutathione (GSSG)

    Measured: 8 weeks

  11. GSH

    Differences between groups regarding dosage of Glutathione (GSH)

    Measured: 8 weeks

  12. GPx

    Differences between groups regarding dosage of Glutathione Peroxidase (GPx)

    Measured: 8 weeks

  13. CAT

    Differences between groups regarding dosage of Catalase (CAT)

    Measured: 8 weeks

  14. TBARS

    Differences between groups regarding dosage of Thiobarbituric Acid Reactive Substances (TBARS)

    Measured: 8 weeks

  15. SOD

    Differences between groups regarding dosage of Superoxide Dismutase (SOD)

    Measured: 8 weeks

  16. Carbonyl

    Differences between groups regarding dosage of Carbonyl

    Measured: 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jan 2017 (estimated)
  2. Study startJan 2017
  3. Primary completionJul 2018 (estimated)
  4. Study completionDec 2018 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03018236
Sponsor's protocol ID
150488
Status last verified
Jan 2017
First submitted
10 Jan 2017
Last updated
24 Jan 2017
Results posted
No
Data monitoring committee
No
Individual data sharing
Undecided

Publications

  • Agrawal A, Verweij KJ, Gillespie NA, Heath AC, Lessov-Schlaggar CN, Martin NG, Nelson EC, Slutske WS, Whitfield JB, Lynskey MT. The genetics of addiction-a translational perspective. Transl Psychiatry. 2012 Jul 17;2(7):e140. doi: 10.1038/tp.2012.54.

    PubMed 22806211
  • Andreazza AC, Frey BN, Valvassori SS, Zanotto C, Gomes KM, Comim CM, Cassini C, Stertz L, Ribeiro LC, Quevedo J, Kapczinski F, Berk M, Goncalves CA. DNA damage in rats after treatment with methylphenidate. Prog Neuropsychopharmacol Biol Psychiatry. 2007 Aug 15;31(6):1282-8. doi: 10.1016/j.pnpbp.2007.05.012. Epub 2007 Jun 2.

    PubMed 17614179
  • Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, Bouvard V, Altieri A, Cogliano V; WHO International Agency for Research on Cancer Monograph Working Group. Carcinogenicity of alcoholic beverages. Lancet Oncol. 2007 Apr;8(4):292-3. doi: 10.1016/s1470-2045(07)70099-2. No abstract available.

    PubMed 17431955
  • Baker DA, McFarland K, Lake RW, Shen H, Toda S, Kalivas PW. N-acetyl cysteine-induced blockade of cocaine-induced reinstatement. Ann N Y Acad Sci. 2003 Nov;1003:349-51. doi: 10.1196/annals.1300.023. No abstract available.

    PubMed 14684458
  • Berk M, Malhi GS, Gray LJ, Dean OM. The promise of N-acetylcysteine in neuropsychiatry. Trends Pharmacol Sci. 2013 Mar;34(3):167-77. doi: 10.1016/j.tips.2013.01.001. Epub 2013 Jan 29.

    PubMed 23369637
  • Bibel M, Barde YA. Neurotrophins: key regulators of cell fate and cell shape in the vertebrate nervous system. Genes Dev. 2000 Dec 1;14(23):2919-37. doi: 10.1101/gad.841400. No abstract available.

    PubMed 11114882
  • Calado RT, Young NS. Telomere diseases. N Engl J Med. 2009 Dec 10;361(24):2353-65. doi: 10.1056/NEJMra0903373. No abstract available.

    PubMed 20007561
  • Chen CH, Pan CH, Chen CC, Huang MC. Increased oxidative DNA damage in patients with alcohol dependence and its correlation with alcohol withdrawal severity. Alcohol Clin Exp Res. 2011 Feb;35(2):338-44. doi: 10.1111/j.1530-0277.2010.01349.x. Epub 2010 Nov 10.

    PubMed 21070251
  • Corominas-Roso M, Roncero C, Daigre C, Grau-Lopez L, Ros-Cucurull E, Rodriguez-Cintas L, Sanchez-Mora C, Lopez MV, Ribases M, Casas M. Changes in brain-derived neurotrophic factor (BDNF) during abstinence could be associated with relapse in cocaine-dependent patients. Psychiatry Res. 2015 Feb 28;225(3):309-14. doi: 10.1016/j.psychres.2014.12.019. Epub 2014 Dec 20.

    PubMed 25592977
  • Costa MA, Girard M, Dalmay F, Malauzat D. Brain-derived neurotrophic factor serum levels in alcohol-dependent subjects 6 months after alcohol withdrawal. Alcohol Clin Exp Res. 2011 Nov;35(11):1966-73. doi: 10.1111/j.1530-0277.2011.01548.x. Epub 2011 Aug 16.

    PubMed 21848960
  • Cross CE, Valacchi G, Schock B, Wilson M, Weber S, Eiserich J, van der Vliet A. Environmental oxidant pollutant effects on biologic systems: a focus on micronutrient antioxidant-oxidant interactions. Am J Respir Crit Care Med. 2002 Dec 15;166(12 Pt 2):S44-50. doi: 10.1164/rccm.2206015.

    PubMed 12471088
  • Davis MI. Ethanol-BDNF interactions: still more questions than answers. Pharmacol Ther. 2008 Apr;118(1):36-57. doi: 10.1016/j.pharmthera.2008.01.003. Epub 2008 Feb 2.

    PubMed 18394710
  • Dean O, Giorlando F, Berk M. N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action. J Psychiatry Neurosci. 2011 Mar;36(2):78-86. doi: 10.1503/jpn.100057.

    PubMed 21118657
  • Degenhardt L, Singleton J, Calabria B, McLaren J, Kerr T, Mehta S, Kirk G, Hall WD. Mortality among cocaine users: a systematic review of cohort studies. Drug Alcohol Depend. 2011 Jan 15;113(2-3):88-95. doi: 10.1016/j.drugalcdep.2010.07.026. Epub 2010 Sep 15.

    PubMed 20828942
  • Ersche KD, Jones PS, Williams GB, Robbins TW, Bullmore ET. Cocaine dependence: a fast-track for brain ageing? Mol Psychiatry. 2013 Feb;18(2):134-5. doi: 10.1038/mp.2012.31. Epub 2012 Apr 24. No abstract available.

    PubMed 22525488

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Alcohol N-acetylcysteine and Cocaine N-acetylcysteine in people with Cocaine Addiction and Alcohol Addiction, run by Hospital de Clinicas de Porto Alegre at 1 site in Brazil.

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 2 inclusion and 9 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: status not confirmed, as of the sponsor's last update on 24 Jan 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Lisia von Diemen, PhD (+55 51 3359 6471, lisiavd@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of participants who attended all study appointments (time frame: 8 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03018236, which also lists 71 linked publications.

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 24 Jan 2017.

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