Gabapentin for Abstinence Initiation in Alcohol Dependence

Overview[ - collapse ][ - ]

Purpose Primary Hypotheses: 1. Gabapentin will significantly reduce the symptoms of alcohol withdrawal as compared to placebo. The primary outcome measure of alcohol withdrawal will be the Clinical Institute Withdrawal Alcohol (CIWA-Ar) (Sullivan, Sykora, Schneiderman, Naranjo, & Sellers, 1989) score. 2. Gabapentin will significantly reduce alcohol consumption and promote abstinence as compared to placebo. The primary outcome measure will be the number of the heavy drinking days (defined as any day where the number of standard drinks was at least 5 for men and at least 4 for women) per week as measured by the timeline follow-back method. Secondary Hypotheses: 1. Gabapentin will be superior to placebo in reducing alcohol use as measured by secondary outcomes such as amount of drinks per day, amount of drinks per drinking day, percent days abstinent and serial measurement of gamma-glutamyl transferase (GGT) serum level.
ConditionAlcohol Dependence
InterventionDrug: Gabapentin
Other: Placebo
PhasePhase 2/Phase 3
SponsorNew York State Psychiatric Institute
Responsible PartyNew York State Psychiatric Institute
ClinicalTrials.gov IdentifierNCT01141049
First ReceivedJune 9, 2010
Last UpdatedJanuary 15, 2014
Last verifiedJuly 2013

Tracking Information[ + expand ][ + ]

First Received DateJune 9, 2010
Last Updated DateJanuary 15, 2014
Start DateAugust 2010
Estimated Primary Completion DateDecember 2012
Current Primary Outcome MeasuresThe number of days of abstinence from alcohol [Time Frame: 8 weeks of trial or length of patient's participation] [Designated as safety issue: No]During the course of 8 weeks the medication aims to determine whether it is effective in treating alcohol withdrawal symptoms, reducing alcohol consumption, and promoting abstinence in alcohol-dependent patients.
Current Secondary Outcome MeasuresNot Provided

Descriptive Information[ + expand ][ + ]

Brief TitleGabapentin for Abstinence Initiation in Alcohol Dependence
Official TitleGabapentin for Abstinence Initiation in Alcohol Dependence
Brief Summary
Primary Hypotheses:

1. Gabapentin will significantly reduce the symptoms of alcohol withdrawal as compared to
placebo. The primary outcome measure of alcohol withdrawal will be the Clinical
Institute Withdrawal Alcohol (CIWA-Ar) (Sullivan, Sykora, Schneiderman, Naranjo, &
Sellers, 1989) score.

2. Gabapentin will significantly reduce alcohol consumption and promote abstinence as
compared to placebo. The primary outcome measure will be the number of the heavy
drinking days (defined as any day where the number of standard drinks was at least 5
for men and at least 4 for women) per week as measured by the timeline follow-back
method.

Secondary Hypotheses:

1. Gabapentin will be superior to placebo in reducing alcohol use as measured by secondary
outcomes such as amount of drinks per day, amount of drinks per drinking day, percent days
abstinent and serial measurement of gamma-glutamyl transferase (GGT) serum level.
Detailed Description
In an 8-week randomized double-blind placebo-controlled outpatient pilot trial the efficacy
of gabapentin in the treatment of alcohol dependence will be studied in 60 patients.
Participants will be randomly assigned to treatment under double-blind conditions with
either 1) a fixed dosing schedule of gabapentin or 2) placebo. All participants will receive
weekly supportive behavioral treatment that promotes abstinence from alcohol and other
substances, encourages mutual-support meeting attendance, and facilitates compliance with
study medication. The primary outcome measures will be: the treatment of alcohol withdrawal
as measured by the CIWA-Ar and the reduction of heavy drinking days per week as measured by
the timeline follow-back method.

Participants will be alcohol-dependent men and nonpregnant women who report drinking a
minimum of 5 standard drinks for men or 4 standard drinks for women at least 4 days per week
over the past 28 days. The daily minimum drinking requirements are consistent with the
commonly accepted definition of "binge drinking." A minimum requirement of having a heavy
drinking episode 4 days a week would select for a population of individuals who are drinking
excessively more days than not. A minimum threshold of weekly alcohol use is set to prevent
a "floor effect" (i.e. participants with minimal alcohol use at baseline would be unable to
demonstrate significant improvement.)
Study TypeInterventional
Study PhasePhase 2/Phase 3
Study DesignAllocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
ConditionAlcohol Dependence
InterventionDrug: Gabapentin
During week 1 the dosage will be increased 3 times. Days 1 and 2, participants will receive 400 mg of Gabapentin three times daily. During days 3 and 4 the dosage will be increased to 800 mg three times daily. On day 5 through 7, participants will receive a dose of 1200 mg three times daily, which will continue from week 2 through 8. During week 9 patients will be tapered off for the duration of the week.
Other Names:
NeurontinOther: Placebo
Placebo, TID
Study Arm (s)
  • Active Comparator: Gabapentin
    Gabapentin will be titrated over a 7-day period to the dose target or the maximum tolerated dose. The maximum dose will be 1200mg TID. Participants must be able to tolerate and comply with at least 400 mg daily.
  • Placebo Comparator: Placebo
    Placebo capsules will be administered TID.

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated Enrollment40
Estimated Completion DateDecember 2012
Estimated Primary Completion DateDecember 2012
Eligibility Criteria
Inclusion Criteria:

- Between the ages of 18-65.

- Meets DSM-IV criteria for current alcohol dependence.

- Seeking treatment for alcohol dependence.

- Reports drinking a minimum of 5 standard drinks for men or 4 standard drinks for
women at least 4 days per week over the past 28 days.

- Able to provide informed consent and comply with study procedures.

Exclusion Criteria:

- Lifetime history of DSM-IV diagnosis of schizophrenia, schizoaffective disorder, or
bipolar disorder.

- A diagnosis of current major depressive disorder or any other current Axis I
psychiatric disorder as defined by DSM-IV-TR, other than alcohol dependence, that in
the investigator's judgment might require intervention with either pharmacological or
non-pharmacological therapy over the course of the study.

- Patients currently taking prescribed psychotropic medications that would be disrupted
by study medication or by an effort to discontinue alcohol use.

- Evidence of moderate-to-severe alcohol withdrawal (CIWA-Ar > 13.

- History of allergic reaction to candidate medication (gabapentin).

- History of alcohol withdrawal seizures or alcohol withdrawal delirium.

- Pregnancy, lactation, or failure to use adequate contraceptive methods in female
patients who are currently engaging in sexual activity with men.

- Unstable medical conditions, such as poorly controlled diabetes or hypertension (>
140/90 mm Hg), which might make participation hazardous.

- Subjects who have a current DSM-IV-TR diagnosis of other substance dependence, with
the exception of nicotine and caffeine dependence. A diagnosis of substance abuse
will not be exclusionary unless significant illicit substance use is present.

- Are legally mandated to participate in an alcohol use disorder treatment program.

- Who by history and current assessment represent a significant risk for suicide.

- Subjects who are likely, based on history, to place themselves in danger (e.g.,
driving while intoxicated or otherwise being unwilling to follow safety precautions).

- Renal insufficiency or abnormal renal function.
GenderBoth
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesUnited States

Administrative Information[ + expand ][ + ]

NCT Number NCT01141049
Other Study ID Numbers#6123
Has Data Monitoring CommitteeYes
Information Provided ByNew York State Psychiatric Institute
Study SponsorNew York State Psychiatric Institute
CollaboratorsNot Provided
Investigators Principal Investigator: John Mariani, MD NYSPI
Verification DateJuly 2013

Locations[ + expand ][ + ]

Substance Treatment and Research Service (STARS)
New York, New York, United States, 10019
New York State Psychiatric Institute
New York, New York, United States, 10032