Alcohol AbstinencePhase 1/2NCT03137082
Guanfacine to Reduce Relapse Risk in Women With Alcohol Use Disorder (AUD)
A Phase 1/2 study testing Guanfacine XR 3mgs/daily in people with Alcohol Abstinence, run by Stony Brook University at 1 site in United States.
Trial summary
Guanfacine may preferentially reduce craving and improve cognitive control in women with Alcohol Use Disorder (AUD), compared to men. As these behaviors are related to relapse, the objectives of this study are to conduct a 10-week out-patient clinical trial to examine the effects of Guanfacine Extended Release (XR… Read more about this study
- Who is it for?
- Ages 18 to 50 years, women only
- Conditions the study is for
- Alcohol Abstinence
- What is being tested?
- Guanfacine XR 3mgs/daily
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 32 participants
- Where
- 1 siteUnited States
- Study dates
- 12 Jul 2017to 31 Mar 2021
- Phase
- Phase 1/2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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 to 50 years
- Women only
- No healthy volunteers
- Adult
Who may be able to join
- Must meet Diagnostic and Statistical Manual of Mental Disorders-V (DSM- V) criteria for moderate to severe Alcohol Use Disorder (AUD),
- Must produce positive urine toxicology screens on admission to study
- Must demonstrate good health as verified by screening examination
- Must be able to read English and complete study evaluations
- Must be able to provide informed written and verbal consent
Who cannot join
- Meeting current use disorder for any other psychoactive substance, excluding nicotine.
- Having any other current Axis I psychiatric disorders or medical conditions requiring treatment or medication
- EKG evidence at baseline screening of any clinically significant conduction abnormalities including a Bazlett's QTc (corrected QT interval) of >470 msec.
- Must not be on monophasic contraceptives, nursing or pregnant.
Trial locations and contacts
1 site in 1 country.
United States1 site
The Health Sciences Center
Stony Brook, New York, 11794
About this study
Guanfacine may preferentially reduce craving and improve cognitive control in women with Alcohol Use Disorder (AUD), compared to men. As these behaviors are related to relapse, the objectives of this study are to conduct a 10-week out-patient clinical trial to examine the effects of Guanfacine Extended Release (XR; 3mgs) versus placebo on drinking measures in women with AUD.
Read the detailed description
Gender-specific variation in sympathetic sensitivity (Fox et al., 2014; Fox and Sinha, 2009; Cahill, 2003; Heinsbroek et al., 1991) may mean that guanfacine is particularly efficacious in attenuating drinking in women, rather than men with Alcohol Use Disorder (AUD). Thus, the investigators propose a double blind, placebo-controlled, 10-week randomized clinical trial to examine the effects of Guanfacine XR (3mgs/daily) versus placebo in 60 women with AUD. This will include twice weekly appointments comprising medical management and contingency management protocols, collection of urine, breathalyzer screens, and vitals. Measures of craving and mood will also be assessed. Parallel laboratory challenge studies will also be conducted both on admission to out-patient treatment and again following 4 weeks of treatment, in order to better elucidate the potentially therapeutic mechanisms of guanfacine. Participants will be exposed to a personal stress versus relaxing imagery condition, 1 condition per day, in a randomized order. Craving, anxiety, mood, cognitive control, heart rate and blood pressure (HRBP), and biological stress system markers will be assessed at baseline, following imagery and at various recovery timepoints.
- Conditions
- Alcohol Abstinence
- Being tested
- Guanfacine XR 3mgs/daily, Placebo (for guanfacine)
- Keywords
- Alcohol Use Disorder, Guanfacine, Stress, Craving, Gender, Relapse
- Medical subject headings
- Alcohol Abstinence, Alcoholism, Coitus, Recurrence
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Guanfacine XR 3mgs/dailyDrug
Also called Intuniv
Guanfacine 3mg tablet
Placebo (for guanfacine)Drug
Also called Sugar pill
Sugar pill manufactured to mimic guanfacine tablets
| Study group | Role | What they receive |
|---|---|---|
| Guanfacine XR 3mgs/daily | Experimental | * Guanfacine XR tablet by mouth every 24 hours for 12 weeks
* 21 day titration: 1 mg/d (day 1-7); 2mgs/d (day 7-21)
* Full dose: 3mgs/d (day 21- day 70)
* 2 week taper: 2mgs/d (day 71-77); 1mg/d (day 77-83) Receives: Drug: Guanfacine XR 3mgs/daily |
| Placebo (for guanfacine) | Placebo comparator | * Guanfacine XR tablet by mouth every 24 hours for 12 weeks
* 21 day titration: 1 mg/d (day 1-7); 2mgs/d (day 7-21)
* Full dose: 3mgs/d (day 21- day 70)
* 2 week taper: 2mgs/d (day 71-77); 1mg/d (day 77-83) Receives: Drug: Placebo (for guanfacine) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Days Abstinent
Percentage of days abstinent across the 12-week trial was calculated using the Timeline follow Back.
Measured: 12 weeks
Percentage of Heavy Drinking Days
Percentage of heavy drinking days across the 12-week trial was calculated using the Timeline follow Back.
Measured: 12 weeks
Alcohol Consumption (Percentage of Negative Urines)
Urine screening will be conducted twice per week across the trial.
Measured: 12 weeks
Secondary outcomes (10)
Mood (Anxiety)
The Anxiety subscale of the Profile of Mood States (POMS) was administered to assess anxiety. The subscale comprises 9 adjectives that describe anxiety-related feelings, and participants are required to rate the extent to which they are experiencing each feeling at that moment, from 0= not at all; 1= a little; 2= moderately; 3= quite a bit; 4= extremely. Possible scores range from 0 to 36, with higher scores representing higher levels of anxiety. Anxiety ratings were collected two times per week across twelve weeks (24 time-points). Each time-point represented change from baseline anxiety. The calculation here represents mean change from baseline values across the 12 weeks, where minus scores represent lower mean anxiety compared with baseline.
Measured: 2 times per week for 12 weeks
Mood (Depression)
The Depression subscale of the Profile of Mood States (POMS) was administered to assess depression. The subscale comprises 15 adjectives that describe depression-related feelings, and participants are required to rate the extent to which they are experiencing each feeling at that moment, from 0= not at all; 1= a little; 2= moderately; 3= quite a bit; 4= extremely. Possible scores range from 0 to 60, with higher scores representing higher levels of depression. Depression ratings were collected two times per week across twelve weeks (24 time-points). Each time-point represented change from baseline depression. The calculation here represents mean change from baseline values across the 12 weeks, where minus scores represent lower mean depression compared with baseline.
Measured: 2 times per week for 12 weeks
Alcohol Craving
The desire for using alcohol was assessed using a 10-point visual analog scale (VAS) in which 1 = 'not at all' and 10 = 'extremely high'. Alcohol craving ratings were collected two times per week across twelve weeks (24 time-points). Each time-point represented change from baseline alcohol craving. The calculation here represents mean change from baseline values across the 12 weeks, where minus scores represent lower mean alcohol craving compared with baseline.
Measured: 12-weeks
Emotion Regulation (Difficulties in Impulse Control)
We used the Impulse Control Difficulties subscale (IMPULSE) of the Difficulties in Emotion Regulation Scale (DERS) to assess changes in impulse control across the trial. The DERS was administered two times per week, and the IMPULSE subscale comprised 6 items with a potential score range of 6 to 30 with higher scores representing greater difficulties in impulse control. Each time-point represents change from baseline impulse control difficulties. The calculation here represents mean change from baseline values across the 12 weeks, where minus values represent less difficulties in impulse control compared with baseline.
Measured: 12-weeks
Emotion Regulation (Difficulties With Engaging in Goal Related Behavior)
We used the Difficulties in Engaging in Goal-Directed Behavior (GOALS) subscale of the Difficulties in Emotion Regulation Scale (DERS) to assess changes in goal-directed behavior across the trial. The DERS was administered two times per week (24 time-points) and the GOALS subscale comprised 5 items with a potential score range of 5 to 25 with higher scores representing greater difficulties in engaging in goal-directed behavior. Each time-point represented change from baseline GOALS. The calculation here represents mean change from baseline values across the 12 weeks, where minus values represent less difficulties in engaging in goal-directed behavior compared with baseline.
Measured: 12-week
Emotion Regulation (Difficulties With Emotional Clarity)
We used the Lack of Emotional Clarity subscale (CLARITY) of the Difficulties in Emotion Regulation Scale (DERS) to assess changes in emotional clarity across the trial. The DERS was administered two times per week, and the CLARITY subscale comprised 5 items with a potential score range of 5 to 25 with higher scores representing greater difficulties in emotional clarity. Each time-point represents change from baseline difficulties in emotional clarity. The calculation here represents mean change from baseline values across the 12 weeks, where minus values represent less difficulties in emotional clarity compared with baseline.
Measured: 12-weeks
Emotion Regulation (Limited Access to Emotion Regulation Strategies)
We used the Limited Access to Emotion Regulation Strategies subscale (STRATEGIES) of the Difficulties in Emotion Regulation Scale (DERS) to assess changes in ability to access emotion regulation strategies across the trial. The DERS was administered two times per week, and the STRATEGIES subscale comprised 8 items with a potential score range of 8 to 40 with higher scores representing greater difficulties in accessing emotion regulation strategies. Each time-point represents change from baseline STRATEGIES. The calculation here represents mean change from baseline values across the 12 weeks, where minus values represent less difficulties in accessing emotion regulation strategies compared with baseline.
Measured: 12-weeks
Emotion Regulation (Difficulties With Emotional Awareness)
We used the Lack of Emotional Awareness subscale (AWARENESS) of the Difficulties in Emotion Regulation Scale (DERS) to assess changes in emotional awareness across the trial. The DERS was administered two times per week, and the AWARENESS subscale comprised of 6 items with a potential score range of 6 to 30 with higher scores representing greater a greater lack of emotional awareness. Each time-point represents change from baseline emotional awareness. The calculation here represents mean change from baseline values across the 12 weeks, where minus values represent less difficulties in emotional awareness compared with baseline.
Measured: 12-weeks
Emotion Regulation (Non-Acceptance of Emotional Responses)
We used the Non-Acceptance of Emotional Responses subscale (NON-ACCEPTANCE) of the Difficulties in Emotion Regulation Scale (DERS) to assess changes in non-acceptance of emotional responses across the trial. The DERS was administered two times per week, and the NON-ACCEPTANCE subscale comprised 6 items with a potential score range of 6 to 30 with higher scores representing greater difficulties in acceptance of emotional response. Each time-point represents change from baseline NON-ACCEPTANCE. The calculation here represents mean change from baseline values across the 12 weeks, where minus values represent less difficulties regarding non-acceptance of emotional responses compared with baseline.
Measured: 12-Week
Emotion Regulation (Total Score)
We used the Total score of the Difficulties in Emotion Regulation Scale (DERS) to assess changes in overall emotion regulation across the trial. The DERS was administered two times per week, and comprised 41 items with a potential score range of 41 to 164 with higher scores representing greater difficulties in emotion regulation. Each time-point represents change from baseline emotion regulation difficulties. The calculation here represents mean change from baseline values across the 12 weeks, where minus values represent less difficulties regarding emotion regulation compared with baseline.
Measured: 12-weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 May 2017
- Study start12 Jul 2017
- Primary completion31 Mar 2021
- Study completion31 Mar 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Alcohol AbstinenceStudies of the same condition, open and under way.
- 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
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 32 participants (actual)
Sponsor and investigators
- Lead sponsor
- Stony Brook University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Helen Fox, Stony Brook University
- Investigators
- Helen C Fox, PhD, Principal investigator, Stony Brook University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03137082
- Sponsor's protocol ID
- R21AA024880
- Status last verified
- May 2024
- First submitted
- 24 Apr 2017
- Last updated
- 5 Jun 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Fox HC, Morgan PT, Sinha R. Sex differences in guanfacine effects on drug craving and stress arousal in cocaine-dependent individuals. Neuropsychopharmacology. 2014 May;39(6):1527-37. doi: 10.1038/npp.2014.1. Epub 2014 Jan 7.
PubMed 24395021Fox HC, Sinha R. Sex differences in drug-related stress-system changes: implications for treatment in substance-abusing women. Harv Rev Psychiatry. 2009;17(2):103-19. doi: 10.1080/10673220902899680.
PubMed 19373619Heinsbroek RP, van Haaren F, Feenstra MG, Boon P, van de Poll NE. Controllable and uncontrollable footshock and monoaminergic activity in the frontal cortex of male and female rats. Brain Res. 1991 Jun 14;551(1-2):247-55. doi: 10.1016/0006-8993(91)90939-s.
PubMed 1913155Cahill L. Sex-related influences on the neurobiology of emotionally influenced memory. Ann N Y Acad Sci. 2003 Apr;985:163-73. doi: 10.1111/j.1749-6632.2003.tb07080.x.
PubMed 12724157Konjusha A, Colzato L, Ghin F, Stock AK, Beste C. Auricular transcutaneous vagus nerve stimulation for alcohol use disorder: A chance to improve treatment? Addict Biol. 2022 Sep;27(5):e13202. doi: 10.1111/adb.13202.
PubMed 36001426
Study at a glance
From the registry record, last updated by the sponsor on 5 Jun 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Guanfacine to Reduce Relapse Risk in Women With Alcohol Use Disorder (AUD)
- ClinicalTrials.gov ID
- NCT03137082
- Acronym / sponsor ID
- R21AA024880
- Conditions
- Alcohol Abstinence
- Keywords
- Alcohol Use Disorder, Guanfacine, Stress, Craving, Gender, Relapse
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 32 participants (actual)
- Lead sponsor
- Stony Brook UniversityUniversity, hospital or other
- Study start
- 12 Jul 2017 (actual)
- Primary completion
- 31 Mar 2021 (actual)
- Study completion
- 31 Mar 2021 (actual)
- First posted
- 2 May 2017 (actual)
- Results
- Posted 5 Jun 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Guanfacine may preferentially reduce craving and improve cognitive control in women with Alcohol Use Disorder (AUD), compared to men. As these behaviors are related to relapse, the objectives of this study are to conduct a 10-week out-patient clinical trial to examine the effects of Guanfacine Extended Release (XR; 3mgs) versus placebo on drinking measures in women with AUD.
Detailed description
Gender-specific variation in sympathetic sensitivity (Fox et al., 2014; Fox and Sinha, 2009; Cahill, 2003; Heinsbroek et al., 1991) may mean that guanfacine is particularly efficacious in attenuating drinking in women, rather than men with Alcohol Use Disorder (AUD). Thus, the investigators propose a double blind, placebo-controlled, 10-week randomized clinical trial to examine the effects of Guanfacine XR (3mgs/daily) versus placebo in 60 women with AUD. This will include twice weekly appointments comprising medical management and contingency management protocols, collection of urine, breathalyzer screens, and vitals. Measures of craving and mood will also be assessed. Parallel laboratory challenge studies will also be conducted both on admission to out-patient treatment and again following 4 weeks of treatment, in order to better elucidate the potentially therapeutic mechanisms of guanfacine. Participants will be exposed to a personal stress versus relaxing imagery condition, 1 condition per day, in a randomized order. Craving, anxiety, mood, cognitive control, heart rate and blood pressure (HRBP), and biological stress system markers will be assessed at baseline, following imagery and at various recovery timepoints.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Guanfacine XR 3mgs/daily | Experimental | Drug: Guanfacine XR 3mgs/daily* Guanfacine XR tablet by mouth every 24 hours for 12 weeks * 21 day titration: 1 mg/d (day 1-7); 2mgs/d (day 7-21) * Full dose: 3mgs/d (day 21- day 70) * 2 week taper: 2mgs/d (day 71-77); 1mg/d (day 77-83) |
| Placebo (for guanfacine) | Placebo comparator | Drug: Placebo (for guanfacine)* Guanfacine XR tablet by mouth every 24 hours for 12 weeks * 21 day titration: 1 mg/d (day 1-7); 2mgs/d (day 7-21) * Full dose: 3mgs/d (day 21- day 70) * 2 week taper: 2mgs/d (day 71-77); 1mg/d (day 77-83) |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Must meet Diagnostic and Statistical Manual of Mental Disorders-V (DSM- V) criteria for moderate to severe Alcohol Use Disorder (AUD),
- Must produce positive urine toxicology screens on admission to study
- Must demonstrate good health as verified by screening examination
- Must be able to read English and complete study evaluations
- Must be able to provide informed written and verbal consent
Key exclusion criteria (4 listed)
- Meeting current use disorder for any other psychoactive substance, excluding nicotine.
- Having any other current Axis I psychiatric disorders or medical conditions requiring treatment or medication
- EKG evidence at baseline screening of any clinically significant conduction abnormalities including a Bazlett's QTc (corrected QT interval) of >470 msec.
- Must not be on monophasic contraceptives, nursing or pregnant.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Guanfacine XR 3mgs/dailyAlso: IntunivGuanfacine 3mg tablet | Drug | Guanfacine XR 3mgs/daily |
| Placebo (for guanfacine)Also: Sugar pillSugar pill manufactured to mimic guanfacine tablets | Drug | Placebo (for guanfacine) |
Primary outcome
Percentage of Days Abstinent
Time frame: 12 weeks
Percentage of days abstinent across the 12-week trial was calculated using the Timeline follow Back.
Percentage of Heavy Drinking Days
Time frame: 12 weeks
Percentage of heavy drinking days across the 12-week trial was calculated using the Timeline follow Back.
Alcohol Consumption (Percentage of Negative Urines)
Time frame: 12 weeks
Urine screening will be conducted twice per week across the trial.
10 secondary outcomes
Mood (Anxiety)
Time frame: 2 times per week for 12 weeks
Mood (Depression)
Time frame: 2 times per week for 12 weeks
Alcohol Craving
Time frame: 12-weeks
Emotion Regulation (Difficulties in Impulse Control)
Time frame: 12-weeks
Emotion Regulation (Difficulties With Engaging in Goal Related Behavior)
Time frame: 12-week
Emotion Regulation (Difficulties With Emotional Clarity)
Time frame: 12-weeks
Emotion Regulation (Limited Access to Emotion Regulation Strategies)
Time frame: 12-weeks
Emotion Regulation (Difficulties With Emotional Awareness)
Time frame: 12-weeks
Emotion Regulation (Non-Acceptance of Emotional Responses)
Time frame: 12-Week
Emotion Regulation (Total Score)
Time frame: 12-weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jun 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 24395021Fox HC, Morgan PT, Sinha R. Sex differences in guanfacine effects on drug craving and stress arousal in cocaine-dependent individuals. Neuropsychopharmacology. 2014 May;39(6):1527-37. doi: 10.1038/npp.2014.1. Epub 2014 Jan 7.
- Background: PubMed 19373619Fox HC, Sinha R. Sex differences in drug-related stress-system changes: implications for treatment in substance-abusing women. Harv Rev Psychiatry. 2009;17(2):103-19. doi: 10.1080/10673220902899680.
- Background: PubMed 1913155Heinsbroek RP, van Haaren F, Feenstra MG, Boon P, van de Poll NE. Controllable and uncontrollable footshock and monoaminergic activity in the frontal cortex of male and female rats. Brain Res. 1991 Jun 14;551(1-2):247-55. doi: 10.1016/0006-8993(91)90939-s.
- Background: PubMed 12724157Cahill L. Sex-related influences on the neurobiology of emotionally influenced memory. Ann N Y Acad Sci. 2003 Apr;985:163-73. doi: 10.1111/j.1749-6632.2003.tb07080.x.
- Derived from this study: PubMed 36001426Konjusha A, Colzato L, Ghin F, Stock AK, Beste C. Auricular transcutaneous vagus nerve stimulation for alcohol use disorder: A chance to improve treatment? Addict Biol. 2022 Sep;27(5):e13202. doi: 10.1111/adb.13202.
- Individual participant dataSharing planned: No
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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.
Helen C Fox, PhD principal investigator
Stony Brook University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Guanfacine XR 3mgs/daily in people with Alcohol Abstinence, run by Stony Brook University at 1 site 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 4 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 5 Jun 2024. 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 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. 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 combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 5 Jun 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
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.
What does the primary outcome measure?
Percentage of Days Abstinent (time frame: 12 weeks). The study lists 3 primary outcomes in all. 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 NCT03137082, which also lists 5 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 5 Jun 2024.