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ADHDEarly Phase 1NCT03680885

Validating a New Non-invasive Approach to Testing Lidocaine Effectiveness

A Early Phase 1 study testing Lidocaine gel and Injected lidocaine in people with ADHD and Controls, run by PhenoSolve, LLC at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This work will assess the reliability of a simple painless test for the effectiveness of the commonly used local anesthetic lidocaine Read more about this study

Who is it for?
Ages 18 to 49 yearsHealthy volunteers can take part
Conditions the study is for
ADHD, Controls
What is being tested?
Lidocaine gel and Injected lidocaine
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
1 siteUnited States
Study dates
1 Aug 2019to 30 Mar 2020
Phase
Early Phase 1
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 to 49 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Report "get numb at dentist"
  • Report "trouble getting numb at dentist"

Who cannot join

  • ADHD, ADD, and other inattention disorders
  • Known adverse reactions to lidocaine;
  • Epilepsy
  • IQ <80
  • Severe head trauma
  • Birth weight <2270 grams
Show all 109Show fewer
  • Severe autism
  • Generalized anxiety disorders (but dental-specific anxiety will not be an exclusion because many of these individuals may be ones with anxiety because of painful dental experiences with lidocaine ineffectiveness)
  • Mouth sores
  • Ehlers Danlos syndrome
  • Red hair
  • Current pregnancy
  • Treatment currently with potassium or potassium-elevating drugs such as renin-angiotensin-aldosterone blockers
  • Angiotensin Converting Enzyme Inhibitors
  • Alacepril (not available in US)
  • Benazepril (Lotensin)
  • Captopril (trade name Capoten)
  • Cilazapril (Inhibace)
  • Delapril (not available in US)
  • Enalapril (Vasotec/Renitec)
  • Fosinopril (Fositen/Monopril)
  • Imidapril (Tanatril)
  • Lisinopril (Listril/Lopril/Novatec/Prinivil/Zestril)
  • Moexipril (Univasc)
  • Perindopril (Coversyl/Aceon/Perindo)
  • Quinapril (Accupril)
  • Ramipril (Altace/Prilace/Ramace/Ramiwin/Triatec/Tritace)
  • Spirapril (Renormax)
  • Temocapril (not available in US)
  • Teprotide (but not active by oral administration and not used in US)
  • Trandolapril (Mavik/Odrik/Gopten)
  • Zofenopril
  • Angiotensin receptor blockers
  • Azilsartan (Edarbi)
  • Candesartan (Atacand)
  • Eprosartan (Teveten)
  • Fimasartan (Kanarb)
  • Irbesartan (Avapro)
  • Losartan (Cozaar)
  • Olmesartan (Benicar/Olmetec)
  • Telmisartan (Micardis)
  • Valsartan (Diovan)
  • Aldosterone antagonists
  • Spironolactone (Aldactone)
  • Eplerenone (Inspra)
  • Renin inhibitors - Aliskiren (Tekturna, Rasilez)
  • Other potassium elevating agents
  • Antibiotics, including penicillin G and trimethoprim
  • Azole antifungals
  • Beta-blockers
  • Herbal supplements, including milkweed, lily of the valley, Siberian ginseng, Hawthorn berries
  • Heparin
  • Nonsteroidal anti-inflammatory medications (NSAIDs)
  • Oral contraceptives containing drospirenone
  • Arm 2 Eligibility
  • Known adverse reactions to lidocaine;
  • Epilepsy
  • IQ <80
  • Severe head trauma
  • Birth weight <2270 grams
  • Severe autism
  • Generalized anxiety disorders (but dental-specific anxiety will not be an exclusion because many of these individuals may be ones with anxiety because of painful dental experiences with lidocaine ineffectiveness)
  • Mouth sores
  • Ehlers Danlos syndrome
  • Red hair
  • Current pregnancy
  • Treatment currently with potassium or potassium-elevating drugs such as renin-angiotensin-aldosterone blockers
  • Angiotensin Converting Enzyme Inhibitors
  • Alacepril (not available in US)
  • Benazepril (Lotensin)
  • Captopril (trade name Capoten)
  • Cilazapril (Inhibace)
  • Delapril (not available in US)
  • Enalapril (Vasotec/Renitec)
  • Fosinopril (Fositen/Monopril)
  • Imidapril (Tanatril)
  • Lisinopril (Listril/Lopril/Novatec/Prinivil/Zestril)
  • Moexipril (Univasc)
  • Perindopril (Coversyl/Aceon/Perindo)
  • Quinapril (Accupril)
  • Ramipril (Altace/Prilace/Ramace/Ramiwin/Triatec/Tritace)
  • Spirapril (Renormax)
  • Temocapril (not available in US)
  • Teprotide (but not active by oral administration and not used in US)
  • Trandolapril (Mavik/Odrik/Gopten)
  • Zofenopril
  • Angiotensin receptor blockers
  • Azilsartan (Edarbi)
  • Candesartan (Atacand)
  • Eprosartan (Teveten)
  • Fimasartan (Kanarb)
  • Irbesartan (Avapro)
  • Losartan (Cozaar)
  • Olmesartan (Benicar/Olmetec)
  • Telmisartan (Micardis)
  • Valsartan (Diovan)
  • Aldosterone antagonists
  • Spironolactone (Aldactone)
  • Eplerenone (Inspra)
  • Renin inhibitors
  • Aliskiren (Tekturna, Rasilez)
  • Other potassium elevating agents
  • Antibiotics, including penicillin G and trimethoprim
  • Azole antifungals
  • Beta-blockers
  • Herbal supplements, including milkweed, lily of the valley, Siberian ginseng, Hawthorn berries
  • Heparin
  • Nonsteroidal anti-inflammatory medications (NSAIDs)
  • Oral contraceptives containing drospirenone

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Jacobi Medical Center

    The Bronx, New York, 10461

Other trials in United States

About this study

Official title: Reliability Testing of a Non-invasive, Pain-free, Taste-based Assessment Approach to Lidocaine Effectiveness

This work will assess the reliability of a simple painless test for the effectiveness of the commonly used local anesthetic lidocaine

Read the detailed description

In prior tests with a convenience sample, subjects who reported that they had no trouble getting numb at the dentist, also got numb with lidocaine gel on the surface of the tongue. That numbness prevented them from being able to taste any flavor until the numbness had worn off. Subjects who reported having trouble getting numb at the dentist, could still taste flavors after the application of lidocaine.

This work will assess the reliability of a taste-based approach for creating a non-invasive way to test lidocaine effectiveness. The controlled trial will assess the ability of lidocaine oral gel to block taste (e.g., sweet) in 20 adults (ages 18-49) half with history of trouble getting numb at the dentist (Arm 2) and half with no trouble (Arm 1). To determine reproducibility, the taste-based test will be done 4 times on different days, twice with lidocaine and twice with a placebo, with randomization and double-blinding. These repeated results will be compared to a fifth assessment, against the "gold standard" of injection of lidocaine, assessed using a dental probe.

On each of four separate visits, in randomized order, the subject will be tested with tastants to the tongue twice after application of a lidocaine gel to the tongue and twice with a placebo gel. After a wait of two-minutes, the three tastants will be tested. The subject is blinded to the taste and the identity of the gel, which have been compounded to look the same.

On the fifth (last) visit, the subject will get an oral injection of lidocaine and the numbness assessed.

The results across the five tests will then be analyzed.

We are testing in separate studies NCT 03563573 and NCT 03676725 the prevalence of lidocaine ineffectiveness in those with Attention Deficit Hyperactivity Disorder (ADHD) and in the general population without ADHD. We believe the prevalence will be higher in ADHD. As a result, in this evaluation we have one Arm "gets numb at the dentist" where exclusion criteria includes ADHD and a second Arm "has trouble getting numb at the dentist" that does not have that exclusion.

Conditions
ADHD, Controls
Being tested
Lidocaine gel, Placebo, Injected lidocaine
Keywords
Lidocaine ineffectiveness, ADHD, ADD
Medical subject headings
Attention Deficit Disorder with Hyperactivity

What participants receive

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

  • Lidocaine gelDrug

    Also called Intervention

    Lidocaine gel 5%, PEG with FD\&C Blue No.1 (Brilliant Blue FCF)

  • PlaceboDrug

    Also called Control gel

    PEG with FD\&C Blue No.1 (Brilliant Blue FCF)

  • Injected lidocaineDrug

    Also called Current practice

    Standard FDA-approved dental injectable lidocaine

Study groups in NCT03680885
Study groupRoleWhat they receive
Reports getting numb at dentistActive comparatorSubjects will be tested twice with lidocaine gel, twice with a Placebo and once with Injected Lidocaine to assess effectiveness of lidocaine. Each assessment will be on a different day.
Receives: Drug: Lidocaine gel; Drug: Placebo; Drug: Injected lidocaine
Reports trouble getting numb at dentistActive comparatorSubjects will be tested twice with lidocaine gel, twice with a Placebo and once with Injected Lidocaine to assess effectiveness of lidocaine. Each assessment will be on a different day.
Receives: Drug: Lidocaine gel; Drug: Placebo; Drug: Injected lidocaine

What is being measured

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

  1. Taste sensation after lidocaine or placebo

    The subject is blinded to the tastant and gel identities. The 3 tastants are tested in randomized order.

    After application of lidocaine gel or placebo to the tongue, and a wait of 2 minutes, the subject's tongue is rubbed with a swab that has been wet with the tastant on the subject's tongue.

    The subject is asked to identify the taste (e.g., sweet).

    Then, on a 5-point scale (0-4, ranging from none to very intense) they are asked to rate the intensity of the taste.

    The process is repeated for each of the three tastants.

    The consistency of the subject responses over the 4 sessions will be analyzed.

    Measured: 4 visits each of 30 minutes within weeks of one another, average ~1 month total

  2. Ability to feel pressure and discomfort after injection of lidocaine into the cheek

    Inject lidocaine as would be done in a dental visit, assess numbness to pressure and discomfort using the Baker Wong FACES scale (0-10) scale of discomfort, ranging from none to intense pain.

    The effectiveness of lidocaine will be assessed, and then the results compared to Outcome 1.

    Measured: 1 visit of 30 minutes after other 4 visits, average ~1 month total

Timeline

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

  1. First posted21 Sep 2018
  2. Study start1 Aug 2019
  3. Primary completion30 Mar 2020
  4. Study completion30 Mar 2020

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
Early Phase 1
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
Half the subjects will have a self-reported history of lidocaine working for them (effective) and half will have a history of difficulty getting numb (ineffective).
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03680885
Sponsor's protocol ID
2018-271
Status last verified
Jul 2020
First submitted
17 Sep 2018
Last updated
15 Jul 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: We plan to share with the FDA the validation of the taste approach to testing lidocaine effectiveness, as part of an IDE application.

Publications

  • Infante MA, Moore EM, Nguyen TT, Fourligas N, Mattson SN, Riley EP. Objective assessment of ADHD core symptoms in children with heavy prenatal alcohol exposure. Physiol Behav. 2015 Sep 1;148:45-50. doi: 10.1016/j.physbeh.2014.10.014. Epub 2014 Oct 23.

    PubMed 25447751
  • Levitt JO. Practical aspects in the management of hypokalemic periodic paralysis. J Transl Med. 2008 Apr 21;6:18. doi: 10.1186/1479-5876-6-18.

    PubMed 18426576
  • Nakai Y, Milgrom P, Mancl L, Coldwell SE, Domoto PK, Ramsay DS. Effectiveness of local anesthesia in pediatric dental practice. J Am Dent Assoc. 2000 Dec;131(12):1699-705. doi: 10.14219/jada.archive.2000.0115.

    PubMed 11143733
  • Segal MM. We cannot say whether attention deficit hyperactivity disorder exists, but we can find its molecular mechanisms. Pediatr Neurol. 2014 Jul;51(1):15-6. doi: 10.1016/j.pediatrneurol.2014.04.014. Epub 2014 Apr 18. No abstract available.

    PubMed 24938135
  • Segal MM, Rogers GF, Needleman HL, Chapman CA. Hypokalemic sensory overstimulation. J Child Neurol. 2007 Dec;22(12):1408-10. doi: 10.1177/0883073807307095.

    PubMed 18174562
  • Segal MM, Douglas AF. Late sodium channel openings underlying epileptiform activity are preferentially diminished by the anticonvulsant phenytoin. J Neurophysiol. 1997 Jun;77(6):3021-34. doi: 10.1152/jn.1997.77.6.3021.

    PubMed 9212254
  • Teicher MH, Polcari A, Fourligas N, Vitaliano G, Navalta CP. Hyperactivity persists in male and female adults with ADHD and remains a highly discriminative feature of the disorder: a case-control study. BMC Psychiatry. 2012 Nov 7;12:190. doi: 10.1186/1471-244X-12-190.

    PubMed 23134619

Questions about this trial

What is this clinical trial studying?

A Early Phase 1 study testing Lidocaine gel and Injected lidocaine in people with ADHD and Controls, run by PhenoSolve, LLC 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 2 inclusion and 109 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 15 Jul 2020. 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. 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?

Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.

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

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.

What does the primary outcome measure?

Taste sensation after lidocaine or placebo (time frame: 4 visits each of 30 minutes within weeks of one another, average ~1 month total). The study lists 2 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 NCT03680885, which also lists 7 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 15 Jul 2020.

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