Pilot Study to Evaluate the Benefits and the Risks of Methylphenidate for the Treatment of Cocaine Dependence
Overview
- Phase
- Phase 2
- Intervention
- Methylphenidate Pill
- Conditions
- Substance-Related Disorders
- Sponsor
- ANRS, Emerging Infectious Diseases
- Locations
- 1
- Primary Endpoint
- Cocaine use
- Status
- Withdrawn
- Last Updated
- 7 years ago
Overview
Brief Summary
This phase II pilot study aims at evaluating the benefits and the risks of methylphenidate (Concerta®) for the treatment of cocaine/crack dependence in terms of cocaine/crack use reduction and adverse events.
Detailed Description
Patients will receive pharmacotherapy based on methylphenidate (18 mg per tablet) with a 3-week titration phase to a maximum dose of 108 mg per day, with a weekly follow-up during 3 months. Socio-demographic and behavioral data will be collected through phone interviews every month. During medical visits, self-administered and clinical questionnaires will collect clinical and behavioral data. Urine drug toxicologies and blood sampling will be performed to gather biological, pharmacokinetic and pharmacodynamic data. This study should identify an effective response-dose of methylphenidate for people with a cocaine use disorder. The methylphenidate should be effective to reduce cocaine use in cocaine-dependent individuals with a good tolerability. The results of pharmacokinetic and pharmacodynamic analyses will give us the effective dose of methylphenidate and some information on toxicity to adapt the surveillance in a future clinical trial.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Diagnosed with cocaine/crack/amphetamine derivate dependence using Diagnostic and Statistical Manual of Mental Disorders (DSM V) (and International Classification of Diseases (ICD 10)) and willing to be abstinent.
- •Having a cocaine/crack positive urinary test.
- •Effective contraception for women of childbearing age.
- •Willing to participate.
- •Registered at social insurance/security.
- •Being able to give consent.
- •Reachable by telephone.
Exclusion Criteria
- •Dependence on alcohol and/or other substances.
- •Hypersensitivity to the active compound methylphenidate or to filler.
- •Glaucoma.
- •Phaeochromocytoma
- •Family history or diagnosis of Gilles de la Tourette syndrome.
- •During treatment with non-selective, irreversible monoamine oxidase (MAO) inhibitors.
- •History of hyperthyroidism or of thyrotoxicosis.
- •Preexisting cardiovascular problems including severe hypertension, heart failure, arterial occlusive disease, angina, haemodynamically significant congenital heart disease, cardiomyopathies, myocardial infarction, potentially life-threatening arrythmias and channelopathies, (disorders caused by the dysfunction of ionic channels).
- •Preexisting cerebrovascular disorders, cerebral aneurism, vascular abnormalities including vasculitis or stroke.
- •Diagnosis or history of severe depression, anorexia nervosa/anorexic disorders, suicidal tendencies, psychotic symptoms, severe mood disorders, mania, schizophrenia, psychopathic/borderline personality disorder
Arms & Interventions
Methylphenidate pill
18 mg tablets with a 3-week titration phase to a maximum dose of 108 mg per day, orally Associated with phone interviews every month, urine drug toxicologies and blood sampling (PK/PD)
Intervention: Methylphenidate Pill
Outcomes
Primary Outcomes
Cocaine use
Time Frame: Evaluated through the study: during the titration phase (day 1, day 4, day 8, day 11, day 15, day 18) and then at the week 4, week 5, week 6, week 7, week 8, week 9, week 10, week 11 and week 12
Difference between weekly cocaine use at M0 and M3 based on the patient self-reports and urinalysis
Secondary Outcomes
- Side effects using the Drug Effects questionnaire (DEQ)(Evaluated at the week 1, week 2, week 4, week 9 and week 12)
- Craving using the Cocaine Craving Questionnaire (CCQ 10-item)(Evaluated during the titration phase (day 1, day 4, day 8, day 11, day 15, day 18) and then at each visit of the two last months (1 visit a week for 2 months))
- Abstinence (urinalysis)(Evaluated during the titration phase (day 1, day 8, day 15, day 18) and then at the week 4, week 5, week 6, week 7, week 8, week 9, week 10, week 11 and week 12)
- Risk practices using the Blood Borne Virus Transmission Risk Assessment Questionnaire (BBV-TRAQ)(Evaluated at the week 1, week 4, week 9 and week 12)
- Psychiatric symptoms - Depression using the Center for Epidemiologic Studies - Depression Scale (CES-D)(Evaluated at the week 1, week 4, week 9 and week 12)
- Psychiatric symptoms - Attention/Deficit using the attention-deficit/hyperactivity disorder Scale (ADHD)(Evaluated at the week 1, week 4, week 9 and week 12)
- Psychiatric symptoms - Sensation Seeking using the 6-item Sensation Seeking Scale (SSQ 6-item)(Evaluated at the week 1, week 4, week 9 and week 12)
- Criminal behaviors(Evaluated at the week 1, week 4, week 9 and week 12)
- Quality of life using the the 12-Item Short Form Health Survey (SF-12)(Evaluated at the week 1, week 4, week 9 and week 12)