Naltrexone for the treatment of amphetamine dependence: a randomised placebo controlled trial

ISRCTN ISRCTN29945787
DOI https://doi.org/10.1186/ISRCTN29945787
Secondary identifying numbers N/A
Submission date
15/11/2007
Registration date
16/11/2007
Last edited
31/05/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Johan Franck
Scientific

Department of Clinical Neuroscience
Section of Drug and Alcohol Dependence Research
Karolinska University Hospital
Stockholm
17176
Sweden

Phone +46 (0)73 966 0736
Email johan.franck@ki.se

Study information

Study designThis was a randomised double-blind placebo-controlled 12 week study.
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific titleNaltrexone for the treatment of amphetamine dependence: a randomised placebo controlled trial
Study objectivesAmphetamine abuse and dependence represents a major public health problem with growing psychiatric, social and economic consequences. The total number of amphetamine abusers world-wide is estimated to 34 million, a figure larger than the combined number of cocaine and heroin abusers. In Sweden, amphetamine is the most commonly abused substance after cannabis and alcohol. To date, the development of an efficacious pharmacotherapy has remained elusive, although the neurobiological effects of amphetamine have been investigated extensively.

Hypothesis:
To investigate the effect of chronic treatment of naltrexone on amphetamine dependence. With the specific aim of assessing the efficacy of naltrexone in comparison to placebo in increasing weeks of abstinence in amphetamine dependent patients.
Ethics approval(s)Ethics approval received from:
1. The Regional Ethical Review Board in Stockholm on the 6th May 2002 (ref: 03-132)
2. The Swedish Medical Products Agency on the 20th August 2002 (ref: 151:2002/26412)

The trial was conducted in accordance with Good Clinical Practice (ICHGCP, 1996) and the Declaration of Helsinki.
Health condition(s) or problem(s) studiedAmphetamine abuse and dependence
InterventionThis was a randomised, double blind, single-site placebo-controlled trial of Naltrexone (NTX) for amphetamine dependence. Post the lead-in period, 80 patients were randomised to either placebo or NTX treatment for 12 weeks. Patients were asked to attend the clinic twice weekly. On the first weekly visit they met with a research nurse, left supervised urine samples, collected the weekly medication (50 mg naltrexone or an identical placebo in blisters of 7 each), dispensed by the research nurse and filled out questionnaires. On the second weekly visit they received relapse prevention therapy from a licensed psychologist and in addition left supervised urine samples. All urine samples were screened for amphetamine, benzodiazepines, cannabis, cocaine (benzoylecgonine), dextropropoxyphen and opiates. Weekly assessments also included craving measures, self reports of drug use and monitoring of adverse events.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)Naltrexone
Primary outcome measureThe primary outcome measure of the study was abstinence from amphetamine use, as measured by negative amphetamine urine samples during 12 weeks of treatment (maximum of 24 samples). All missing urine samples were imputed as positive in the analysis. The primary analysis was carried out according to the Intention-To-Treat (ITT) approach.
Secondary outcome measuresSecondary outcomes measures included the following:
1. Self reported use of amphetamine (as measured by Timeline Follow Back)
2. Self reported use of alcohol and other drugs of abuse (as measured by Timeline Follow Back)
3. Compliance to treatment, defined as:
3.1. 16/24 urine samples
3.2. Medication compliance, detected by the presence of 6-β-naltrexol in the urine
3.3. Pill counts
4. Craving for amphetamine, measured by the amphetamine craving scale
5. Adverse events, monitored by the study physician and weekly self-report by patient

All secondary outcome measures were evaluated on a weekly basis.
Overall study start date10/01/2003
Completion date23/06/2005

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants80
Total final enrolment80
Key inclusion criteria1. Adult male or female between 18 to 65 years
2. Written, informed consent to participate
3. Address and telephone in the Stockholm metropolitan area where the participant can be reached
4. Amphetamine dependence according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria
5. Having used amphetamine on a minimum of 12 occasions during the 12 weeks prior to screening
6. Two consecutive urine tests with no traces of amphetamine following screening
Key exclusion criteria1. Opiate abuse or dependence
2. Use of any opiate preparation (legal or illicit) during 30 days prior to screening
3. Presence of opiates in urine at screening
4. Other mental disorders than substance abuse/dependence considered to be severe and requiring treatment (dementia, severe depression with suicidal ideation, acute psychotic symptoms, schizophrenia - concurrent pharmacological treatment for depression, and mild psychotic symptoms such as paranoid ideation or other forms of milder delusions for which the patient has some degree of insight do not constitute exclusion criteria)
5. Ongoing treatment with benzodiazepines
6. Acute withdrawal symptoms at screening, irrespective of cause
7. Serious somatic disorder (e.g., cancer, moderate to severe hypertension, advanced atherosclerosis, liver cirrhosis, or other disorders considered to be a risk)
8. Known hypersensitivity to naltrexone
Date of first enrolment10/01/2003
Date of final enrolment23/06/2005

Locations

Countries of recruitment

  • Sweden

Study participating centre

Department of Clinical Neuroscience
Stockholm
17176
Sweden

Sponsor information

Addiction Centre Stockholm (Beroendecentrum Stockholm) (Sweden)
Hospital/treatment centre

Magnus Huss M4:02
Karolinska University Hospital
Stockholm
17176
Sweden

Email johan.franck@ki.se
Website http://www.beroendecentrum.com/
ROR logo "ROR" https://ror.org/04g380834

Funders

Funder type

Government

Swedish Science Council (Sweden)

No information available

The Swedish National Drug Policy Coordinator (Sweden)

No information available

The Stockholm County Council (Sweden)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/11/2008 31/05/2019 Yes No

Editorial Notes

31/05/2019: Publication reference and total final enrolment added.