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Guanfacine for Alcohol Use Disorder (AUD)

Phase 2
Not yet recruiting
Conditions
Alcohol Use Disorder
Interventions
Registration Number
NCT06629259
Lead Sponsor
Indiana University
Brief Summary

The investigators assess whether guanfacine extended release (GXR; 3mg/d) compared with placebo (PBO) will attenuate drinking and drinking-related factors in N=200 men and women with Alcohol Use Disorder (AUD) across 12-weeks.

Detailed Description

This is a study to examine the efficacy of guanfacine extended release (GXR) (3mg/d) compared with placebo (PBO) in reducing drinking in N=200 men and women with Alcohol Use Disorder (AUD). The study will be conducted across two sites for 12-weeks. Indiana University will be the primary site and Rutgers University, the secondary site. Participants at both sites will be randomized to either GXR (3mg/d) or placebo (PBO), and titrated to full dose over a three week period. After remaining at full dose for 7 weeks a two week schedule will be used to taper participants off the medication. During the study the investigators will collect brief reports throughout the day and evening of drinking severity, stress, craving, mood, arousal, anxiety, and emotion regulation at weeks 1 and 2 (baseline) and weeks 5 and 6 (steady state). Additionally, blood alcohol concentration (BAC) levels will be collected three times per day for the full 12-weeks. Daily encrypted video recordings will be used to monitor medication compliance, and participants will also take part in twice weekly remote visits to assess safety, vitals, collect urines, monitor alcohol use, and receive weekly Medical Management. It is anticipated that guanfacine will demonstrate greater efficacy in women compared to men with AUD.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria
  • be assigned as a biological male or female at birth and identify as such
  • meet current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V) criteria for moderate to severe AUD
  • be ≥18 years old and have a body mass index (BMI) of 18-35
  • express a desire to quit alcohol as determined by the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES)
  • demonstrate a positive urine for alcohol on admission to study procedures
  • be able to provide informed verbal and written consent
  • be able to read English and complete study evaluations
  • be in good health as verified by the intake 1 physical examination
Exclusion Criteria
  • meet criteria for moderate to severe Substance Use Disorder (SUD), excluding alcohol and nicotine
  • have a positive screen for substances of abuse, excluding alcohol, nicotine,
  • being psychotic or otherwise severely psychiatrically disabled (including suicidal, homicidal, current mania)
  • meet criteria for physiological dependence on alcohol requiring medical detoxification
  • regular use of medications in the last 6 months that, in the opinion of the site physician may be contraindicated with GXR and be potentially harmful to the participant
  • be pregnant or breast feeding
  • be using monophasic contraceptives
  • have cardiovascular disease including high blood pressure,
  • be hypotensive with sitting blood pressure below 100/50 mmHG
  • have bradycardia with a sitting heart rate (HR) of <60 bpm
  • show EKG evidence of any clinically significant conduction abnormalities, including a Bazett's corrected QT interval (QTc) >470 msec for women and QTc>450 msec for men.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Guanfacine Extended Release (XR)Guanfacine Extended Release (XR)Participants receive guanfacine XR, 3mg tablet orally, once per day for 12 weeks
PlaceboPlaceboParticipants receive guanfacine XR, placebo tablet orally, once per day for 12 weeks
Primary Outcome Measures
NameTimeMethod
Change in % number of days drinkingfive times daily during weeks 1, 2, 5, 6 and twice weekly through week 12

Self-reports of alcohol use

Change in Blood Alcohol Concentration (BAC) levelsthree times per day through week 12.

BAC levels will be collected using a remote breathalyzer application called BACtrack

Change in no. of drinks consumed following stressfive times daily during weeks 1, 2, 5, 6

Self reports of alcohol use will be collected following stress, which will be measured using a visual analog scale (VAS) anchored from 0 (not stressed at all) to 100 (extremely stressed).

Change in alcohol craving following stressfive times daily during weeks 1, 2, 5, 6

Self-reports of alcohol craving will be collected using a VAS anchored from 0 (Not craving at all) to 100 (Craving extremely) following self-reported stress. The VAS for stress will be anchored from 0 (not stressed at all) to 100 (extremely stressed).

Secondary Outcome Measures
NameTimeMethod
Change in number of drinks consumed per occasionfive times daily during weeks 1, 2, 5, 6 and twice weekly through week 12

Self-reports of alcohol use

Change in number of binge episodesfive times daily during weeks 1, 2, 5, 6 and twice weekly through week 12

Self-reports of alcohol use

Change in negative mood following stressfive times daily during weeks 1, 2, 5, 6

Self-reports of negative mood will be collected using The Positive and Negative Affect Schedule (PANAS) following self-reported stress (visual analog scale; VAS). The PANAS is scored from 10-50, with a higher score representing greater negative mood. The VAS for stress will be anchored from 0 (not stressed at all) to 100 (extremely stressed).

Change in anxiety following stressfive times daily during weeks 1, 2, 5, 6

Self-reports of anxiety will be collected using The Positive and Negative Affect Schedule (PANAS) following self-reported stress (visual analog scale; VAS). The PANAS is scored from 10-50, with a higher score representing greater anxiety. The VAS for stress will be anchored from 0 (not stressed at all) to 100 (extremely stressed).

Change in arousal following stressfive times daily during weeks 1, 2, 5, 6

Self-reports of arousal will be collected using The Positive and Negative Affect Schedule (PANAS) following self-reported stress (visual analog scale; VAS). The PANAS is scored from 10-50, with a higher score representing greater arousal. The VAS for stress will be anchored from 0 (not stressed at all) to 100 (extremely stressed).

Change in emotion regulation following stressfive times daily during weeks 1, 2, 5, 6

Self-reports of emotion regulation will be collected using The Difficulties in Emotion Regulation Scale (DERS) developed for ecological momentary assessment (EMA) following self-reported stress (visual analog scale; VAS). The DERS is scored from 36-180 across all items, with a higher score representing greater difficulties in regulating emotion. The VAS for stress will be anchored from 0 (not stressed at all) to 100 (extremely stressed).

Trial Locations

Locations (2)

Rutgers School of Health Professionals

🇺🇸

Newark, New Jersey, United States

The Stark Neuroscience Building (Goodman Hall)

🇺🇸

Indianapolis, Indiana, United States

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