Modafinil Combined With Cognitive Behavior Therapy to Treat Cocaine Addiction - 1

Phase 2

Completed

Conditions: Cocaine Dependence

Interventions: Drug: Matching Placebo
Drug: Modafinil

Registration Number: NCT00218387

Lead Sponsor: Medical University of South Carolina

Brief Summary: Cocaine addiction is a serious health problem with no available medical treatment for preventing relapse. Modafinil, a medication that enhances mood, increases energy, and improves concentration, may be useful in preventing relapse among individuals with cocaine addiction. This study will evaluate the effectiveness of modafinil, in combination with cognitive behavior therapy (CBT), to prevent drug relapse among cocaine addicts.

Detailed Description: The development of a medication to treat cocaine addiction specifically by lessening withdrawal symptoms has been a primary focus of research. Common cocaine withdrawal symptoms include depression, lack of energy, and poor concentration. Modafinil, a central nervous system stimulant, is a medication that can speed up physical and mental processes in the brain. It is currently used to treat narcolepsy, a condition that causes excessive sleepiness. Modafinil enhances mood, increases energy, and improves concentration in people with narcolepsy. Modafinil may also cause the same effects in individuals addicted to cocaine, thereby countering the symptoms of cocaine withdrawal. The purpose of this study is to compare the effectiveness of modafinil plus CBT versus placebo plus CBT for treating cocaine dependence.

A 2-week screening period will be followed by an 8-week treatment phase. Participants will be randomly assigned to receive either 200 mg of modafinil, 400 mg of modafinil, or placebo on a daily basis for the 8 weeks of treatment. During this time, participants will be asked to report the number of days that they use and do not use cocaine. This will be confirmed three times a week with urine tests. Mood, level of daytime sleepiness, and symptoms of cocaine withdrawal and cocaine "high" will be evaluated. Compliance with study medication will be assessed with urine and blood tests. Medication side effects will be monitored through physical examinations, routine lab tests, ECGs, and self-reports. Follow-up evaluations will occur 4 and 8 weeks following the end of treatment.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 123

Inclusion Criteria

Seeking treatment for cocaine dependence
Meets DSM-IV diagnosis criteria for cocaine dependence as determined by Mini-SCID interview
If female, willing to use effective contraception throughout the study
Lives within 50 miles of the research center and has reliable transportation

Exclusion criteria:

Meets DSM-IV/Mini-SCID diagnosis criteria for dependence on any drugs other than cocaine, alcohol, nicotine, or marijuana
Physiologic dependence on alcohol requiring medical detoxification, on either an inpatient or outpatient basis
Current psychiatric disorder, including depression, schizophrenia, bipolar affective disorder, organic brain disease, dementia, or other types of psychosis
Recent suicidal or homicidal attempts within 60 days of study entry
Suicidal or homicidal ideation within 30 days of study entry
Meets diagnosis criteria from the Differential Diagnosis of Psychotic Disorders section of Mini-SCID for a history of psychotic symptoms during a period of cocaine use (e.g., persistent hallucinations and delusions)
Serious medical illness, including left ventricular hypertrophy, mitral valve prolapse, left bundle branch block, heart attack, angina, serious liver disease (transaminase levels four times greater than normal), and kidney, neurologic, metabolic, neoplastic, nutritional, inflammatory, or endocrine disorders
Required by the court to obtain treatment for cocaine dependence
Not seeking treatment for cocaine dependence
Participated in cocaine treatment (clinical or research) within 30 days of study entry
Anticipating elective surgery or hospitalization within 20 weeks of study entry
Known or suspected hypersensitivity to modafinil
Use of any of the following medications within 14 days of study entry: selective serotonin reuptake inhibitor antidepressants, tricyclic antidepressants, dopamine agonists, and other psychotropic medications, including anticonvulsants, antipsychotics, anxiolytics, or psychostimulants
Currently taking medications that could adversely interact with study medications, including azole-type antifungals, cyclosporine, warfarin, theophylline, or carbamazepine
Currently taking any medications that induce or inhibit CYP3A4 metabolic pathways
Pregnant or breastfeeding

Exclusion Criteria

Not provided

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Matching Placebo	Matching Placebo	Matching Placebo
200mg Modafinil	Modafinil	200mg Modafinil
400mg Modafinil	Modafinil	400mg Modafinil

Primary Outcome Measures

Name	Time	Method
Number of Cocaine Non-use Days	8 weeks	Number of cocaine non-use days was determined by Urine Drug Screen tests which confirmed presence (or no presence) of benzoylecgonine levels.
Percent of Participants With New Use	8 weeks	New Use is defined as a period of at least 7 days abstinence followed by a positive urine drug screen.

Secondary Outcome Measures