Contact information
Type
Scientific
Primary contact
Dr Johan Franck
ORCID ID
Contact details
Department of Clinical Neuroscience
Section of Drug and Alcohol Dependence Research
Karolinska University Hospital
Stockholm
17176
Sweden
+46 (0)73 966 0736
johan.franck@ki.se
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
N/A
Study information
Scientific title
Naltrexone for the treatment of amphetamine dependence: a randomised placebo controlled trial
Acronym
Study hypothesis
Amphetamine 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
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.
Study design
This was a randomised double-blind placebo-controlled 12 week study.
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Hospitals
Trial type
Treatment
Patient information sheet
Condition
Amphetamine abuse and dependence
Intervention
This 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 type
Drug
Phase
Not Specified
Drug names
Naltrexone
Primary outcome measure
The 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 measures
Secondary 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 trial start date
10/01/2003
Overall trial end date
23/06/2005
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. 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
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
80
Total final enrolment
80
Participant exclusion criteria
1. 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
Recruitment start date
10/01/2003
Recruitment end date
23/06/2005
Locations
Countries of recruitment
Sweden
Trial participating centre
Department of Clinical Neuroscience
Stockholm
17176
Sweden
Sponsor information
Organisation
Addiction Centre Stockholm (Beroendecentrum Stockholm) (Sweden)
Sponsor details
Magnus Huss M4:02
Karolinska University Hospital
Stockholm
17176
Sweden
-
johan.franck@ki.se
Sponsor type
Hospital/treatment centre
Website
Funders
Funder type
Government
Funder name
Swedish Science Council (Sweden)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Funder name
The Swedish National Drug Policy Coordinator (Sweden)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Funder name
The Stockholm County Council (Sweden)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list
2008 results in: https://www.ncbi.nlm.nih.gov/pubmed/18765480 (added 31/05/2019)